Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is characterized by the presence of left ventricular hypertrophy (thickening of the heart muscle). It can be obstructive - with obstruction of the left ventricular outflow tract caused significant thickening of intraventricular septum subaortnog work, which contributes to the anterior mitral valve and nonobstructive - when there is an equal septal hypertrophy and left ventricular free wall. Contractile function of the left ventricle is preserved.

The cause of

The etiology of hypertrophic cardiomyopathy is not known. However, it seems that the genetic factor is very important. It is often found in close relatives and is inherited in an autosomal - dominant.

The clinical picture

The clinical picture varies from asymptomatic state to sudden cardiac death. In younger patients the disease can flow without symptoms, the chance discovery of systolic murmur, and additional methods to reveal the nature of the disease. The most common symptom was dyspnea (shortness of breath) on exertion, which is due to increased end-diastolic pressure in the left ventricle and the pulmonary veins, because the difficulty of left ventricular filling. Anginal pain occurs due to the disparity between supply and increased demand hypertrophic myocardium. The pain usually does not respond to nitroglycerin, which may be of diagnostic value. Syncope (transient loss of consciousness) or conditions near syncope, due to the low cardiac output and very frequent ventricular arrhythmias. Syncope usually occurs on exertion. Frequent and sudden cardiac death, especially younger people. In odmaklijem stage disease may develop congestive heart failure, which usually occurs after the onset of atrial fibrillation.

Diagnosis

It is based on history, clinical findings, objective examination, ECG, x-ray, ultrasound, cardiac catheterization and angiography.

Treatment

Treatment consists of a quart of physical effort and giving beta blockers. In about 60% of patients in whom beta-blockers are ineffective, verapamil leads to a subjective state of repair. In patients who have severe ventricular arrhythmias is necessary and efficacious application, most notably disopyramide and amiodarone. If there is chronic atrial fibrillation, and given oral and anticoagulant therapy. In patients with refractory symptoms may be applied dvokomorski pacemaker. If, despite these procedures in the treatment of persistent symptoms and the pressure gradient at rest of more than 50 mmHg, then it is a surgical septal myotomy or myomectomy.