Hypertrophic Cardiomyopathy
What are the three main classes of cardiomyopathy? - correct answer 1. Hypertrophic
2. Dilated (Congestive)
3. Restrictive (Infliltrative)
Secondary cardiomyopathies: Five other systemic diseases that affect the myocardium in a similar manner are caused by? - correct answer 1. Viruses
2. Ischemia
3. Metabolic abnormalities - endocrinopathies
4. Hypertension
5. Toxic reactions
What is hypertrophic cardiomyopathy? (HCM) - correct answer 1. It is idiopathic asymmetric hypertrophy of the heart with the greatest affinity for the septum.
2. It is an autosomal dominant trait and thus is an inherited disorder
3. It is a hypertrophic, hyperdynamic and non-dilated LV
What are the causes/classification of Hypertrophic cardiomyopathy? - correct answer 1. Nonobstructive
2. Obstructive
3. Latent obstructive
What are the Maron classification of hypertrophic cardiomyopathies? - correct answer 1. Type I (10%)
-Anterior portion of the ventricular septum
2. Type II (20%)
-Anterior and posterior segments of septum
3. Type III (52%)
-Septum and anterolateral free wall 4. Type IV (18%)
-Involves LV regions other than the anterior septum and the posterior free wall
In the classifications which is the most prominent type? - correct answer Type III (52%)
-Septum and anterolateral free wall
What are the three HEMODYNAMIC types of HCM? - correct answer 1. Obstructive (HOCM)
2. Midventricular obstructive
3. Non-obstructive
Characteristics of HOCM: - correct answer The obstruction is sub aortic due to SAM of MV
SAM = systolic anterior motion
Characteristics of mid ventricular obstructive: - correct answer Occurs at the papillary muscle level without SAM
Characteristics of Non-obstructive HCM: - correct answer 1. Abscense of resting gradient
2. Supranormal/normal LV systolic fx - may have diastolic dysfunction
3. Impaired systolic function end stage
4. LVOT may be larger with no ASH (asymmetric septal hypertrophy)
5. May see ASH
6. If cavity obliteration is seen it is not a TRUE cardiomyopathy
-like hypertensive HCM of elderly with hyperkinesis (EF 95-99%)
What did HOCM used to be called? - correct answer IHSS - Idiopathic hypertrophic subaortic stenosis
What does HOCM stand for? - correct answer Hypertrophic obstructive cardiomyopathy
What ways could the obstruction be? - correct answer 1. Latent - dormant
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