Cardiovascular Medicine Book

http://www.fpnotebook.com/

Hypertrophic Cardiomyopathy

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  1. Epidemiology
    1. Familial: Autosomal Dominant with variable penetrance
  2. Pathophysiology
    1. Primary ventricular hypertrophy
      1. Contrast with secondary Left Ventricular Hypertrophy
    2. Asymmetric thickening of ventricular septum
      1. Outflow obstruction (25%)
      2. Abnormal diastolic filling
    3. Sudden death secondary to Ventricular Tachycardia
  3. History (Often no history is elicited)
    1. Dyspnea
    2. Angina
    3. Dizziness
    4. Syncope with Exercise (60%)
    5. Family History of Sudden death (20%)
  4. Physical Exam
    1. Systolic Murmur at Left Sternal Border
      1. Sounds like flow murmur
      2. Accentuated with standing
      3. Diminished with squatting
    2. Biphasic pulse
  5. Diagnostics
    1. Electrocardiogram (changes seen in 90% of cases)
      1. Ventricular hypertrophy
      2. Deep Q waves
      3. Cardiac Ischemia
    2. Echocardiogram
      1. Definitive test for diagnosis
      2. Septum wider than 15mm confirms diagnosis

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