Overview of hypertrophic cardiomyopathy management including treatment of special problems
- Martin S Maron, MD
Martin S Maron, MD
- Assistant Professor of Medicine
- Tufts University School of Medicine
Hypertrophic cardiomyopathy (HCM) is a genetically determined heart muscle disease most often (60 to 70 percent) caused by mutations in one of several sarcomere genes which encode components of the contractile apparatus. (See "Hypertrophic cardiomyopathy: Gene mutations and clinical genetic testing".)
HCM is characterized by left ventricular hypertrophy of various morphologies, with a wide array clinical manifestations and hemodynamic abnormalities. Depending in part upon the site and extent of cardiac hypertrophy, HCM patients can develop one or more of the following abnormalities:
- LV outflow obstruction (see "Hypertrophic cardiomyopathy: Morphologic variants and the pathophysiology of left ventricular outflow tract obstruction")
- Diastolic dysfunction
- Myocardial ischemia
- Mitral regurgitation
These structural and functional abnormalities can produce a variety of symptoms, including:
- Chest pain
- Presyncope or syncope
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- SPECIAL PROBLEMS AND ISSUES
- LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION ASSOCIATED WITH ACUTE HEMODYNAMIC COLLAPSE
- PREGNANCY AND DELIVERY
- CHILDREN WITH HCM
- Presentation and diagnosis
- Differential diagnosis
- - Mechanisms
- Management of LV outflow obstruction
- ANTICOAGULATION AND ENDOCARDITIS PROPHYLAXIS
- PERIOPERATIVE MANAGEMENT
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS