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Hypertrophic Cardiomyopathy

Epidemiology
1. Familial: Autosomal Dominant with variable penetrance
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
History (Often no history is elicited)
1. Dyspnea
2. Angina
3. Dizziness
4. Syncope with Exercise (60%)
5. Family History of Sudden death (20%)
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
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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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.