Hypertrophic Cardiomyopathy (HCM)

Etiology

  • Idiopathic, genetic or mixed causes
  • Can present from kids to adults
  • Can have symmetric, focal or obstructive hypertrophy
  • Affected areas of the ventricle are thickened; at microscopic level, myocytes are not correctly arrayed

Risk Factors

  • Family history

Symptoms

  • Initially asx, then can develop DOE, SOB, fatigue, and other symptoms of heart failure
  • Chest pain, palpitations
  • A fib often develops, which can exacerbate sx
  • Presyncope/syncope or sudden death can occur from spontaneous VT

Physical Exam Findings

  • Non-obstructive hypertrophy may have no findings unless/until heart failure develops
  • With dz obstructing outflow track--> crescendo decrescendo systolic murmur, loudest along L sternal border; Intensity increases w/decreased preload--> valsalva, standing; Intensity decreases w/increased preload--> squatting

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