Hypertrophic Cardiomyopathy

Question 1

Define what hypertrophic cardiomyopathy is

Answer 1

Disease where a portion of myocardium is enlarged creating functional impairment of the heart

Question 2

What is the epidemiology?

Answer 2

Its the leading cause of death in young adults and athletes

Autosomal dominant but 50% sporadic

Question 3

What is the aetiology?

Answer 3

Genetic 50% ~ mostly MYBAC3
Idiopathic
Amyloidosis 
Haemochromatosis 
Sarcoidosis 
Scleroderma 
Lofflers Eosinophilic endocarditis 
Endomyocardial Fibrosis

Question 4

What are the clinical symptoms?

Answer 4

Asymptomatic 
Fatigue 
Dyspnoea 
Angina 
Palpitations
Sudden death

Question 5

What are the clinical examinations and signs?

Answer 5

Double apex beat
Jerky pulse/Irregular if in AF or ectopy
Alpha wave in JVP
Systolic thrill at lower left sternal edge
Harsh ehection systolic murmur

Question 6

What are the investigations?

Answer 6

ECG
ECHO
Exercise test - continuous BP monitoring

Question 7

What are you looking for in an ECG?

Answer 7

LVH
progressive T wave inversion
deep Q wave
AF

Question 8

What are you looking for in an ECHO?

Answer 8

MR SAM ASH

mitral regurg, systolic anterior movement of mitral valve, assymetrical septal hypertrophy

Question 9

What is the medicinal treatment?

Answer 9

B-Blocker or Verapamil (for symptoms)
Amiodarone (for arrythmias - AF,VT)
Anti-coagulation
Calcium channel blockers

Question 10

What are the surgical options?

Answer 10

Septal myomectomy
Implantable defibrillator
Dual chamber pacing

Question 11

What is the general treatment?

Answer 11

Avoid dehydration
Avoid heavy exercise
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