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5 Cards in this Set
- Front
- Back
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HoCM
- Clinical sx |
- Jerky pulse character
- Double apical impulse (palpable atrial and ventricular contraction) - Thrill at L) lower sternal edge - Auscultation: Ejection systolic murmur at the L) sternal edge which radiates throughout the precordium. Ass/w MVP (ejection click and late systolic murmur) - ESM is accentuated by reducing blood flow through the heart (Valsalva) |
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HoCM
- Additional sx |
- Associated MVP
- Features of Fredreich’s ataxia or myotonic dystrophy - FHx |
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HoCM
- Ix |
ECG: LVH w LV strain and LAD
CXR: often NAD TTE: asymmetrical septal hypertrophy and systolic anterior motion of the anterior mitral leaflet on M-mode |
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HoCM
- Mx |
Rhythm disturbance/ high risk of sudden death
- ICD LVOT gradient > 30mmHg and sx (breathlessness, syncope/presyncope and angina) - B-blockers (avoid diuretics/nitrates) - Pacemaker - Percutaneous septal ablation - Surgical septal myomectomy/partial excision of the septal papillary mscle - Avoid strenuous sport - Family councelling and screening (auto dom inheritance) |
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HoCM
- Prognosis |
- annual mortality rate 2.5% in adults
- Poor prognostic factors: o Young age at dx o Syncope o FHx of sudden death o Septal thickness >3cm |
