Medicogramalmost 7 years ago

Hypertrophic cardiomyopathy

That septum definitely looks thick! Hypertrophic cardiomyopathy is a condition in which the myocardium becomes thickened, making the heart muscle stiff, especially of the septum and ventricles (lower heart chambers), which is seen very clearly in this picture. The pathophysiology behind it is that the sarcomeres (contractile elements) in the heart replicate causing heart muscle cells to increase in size, which results in the thickening of the heart muscle. In addition, the normal alignment of muscle cells is disrupted, a phenomenon known as myocardial disarray. The average left ventricular wall thickness in normal adults is 1.1 cm, but there are exceptions. Trained athletes have hearts that have left ventricular mass up to 60% greater than untrained subjects, with an average left ventricular wall thickness of 1.3 cm. The most common cause is hypertension. As many as 1/3 of patients show left ventricular hypertrophy of any degree along with hypertension. Symptoms are quite variable and range from no symptoms, to the development of heart failure, to the occurrence of sudden cardiac death. Symptoms include dyspnea (shortness of breath) due to stiffening and decreased blood filling of the ventricles, exertional chest pain (angina) due to reduced or restricted blood flow to the coronary arteries, uncomfortable awareness of a fluttering or pounding heart beat (palpitations) due to the ischemia to the heart muscle, disruption of the electrical system running through the abnormal heart muscle, lightheadedness, fatigue, fainting (called syncope) and sudden cardiac death. Treatment goals are to minimize diastolic dysfunction, reducing LV outflow tract obstruction, optimizing heart failure management, maintaining normal sinus rhythm, rate control and anticoagulation in the presence of atrial fibrillation, and implantation of an automatic implantable cardiac defibrillator in those patients who survive sudden cardiac death. 📷•Medicogram•