L36

Question 1

What type of hypertrophy is seen in hypertrophic CM

Answer 1

ASYMMETRICAL

Preference to septum

Question 2

Histo of hypertrophic CM

Answer 2

Myocardial disarray

Question 3

Genetic mutation for hypertrophic CM

Answer 3

Sarcomere mutation

B myosin heavy chain

Question 4

Pathophys

Answer 4

Hypertrophy - stiff
High LV diastolic P
HF

Question 5

Are most hypertrophic CM obstructive?

Answer 5

NO

75% non-ob

Question 6

4 symptoms of obstructive hypertrophic CM

Answer 6

Same as aortic senosis:

• CHF
• Angina
• Syncope
• Sudden death

Question 7

What causes obstruction during HOMC

Answer 7

Systolic anterior motion of mitral valve

Question 8

HOMC murmur

Answer 8

Like AS
- High velocity flow murmur
Different - changes with position

Question 9

What makes the HOMC murmur louder? Softer?

Answer 9

Softer = squats b/c increasing blood volume in heart
Louder = valsalva (decrease preload)

Question 10

Avoid what drugs with HOCM

Answer 10

Inotropes - don’t want to increase contractility

Question 11

What is the carotid pulse for HOCM

Answer 11

Pulses bisferiens
Spike = initial rapid ventricular emptying
Dome = obstruction reflected waves return from periphery