Hypertrophic cardiomyopathy history and symptoms: Difference between revisions
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{{Hypertrophic cardiomyopathy}} | {{Hypertrophic cardiomyopathy}} | ||
''' | '''Editor(s)-In-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com] {{AE}}{{Soroush}} | ||
==Overview== | ==Overview== | ||
The symptoms associated with hypertrophic cardiomyopathy are quite variable and range from no symptoms, | A large number of the patients with hypertrophic cardiomyopathy are [[asymptomatic]] or complain of mild nonspecific [[symptoms]], Patients are often diagnosed by family [[Screening (medicine)|screening]], incidental [[Heart murmur|murmur]] auscultation during routine examination or screening for school athletic events, or via an abnormal [[The electrocardiogram|ECG]]. Nevertheless, in [[symptomatic]] patients, [[left ventricular]] outflow tract gradients and result in symptoms of [[dyspnea]], [[fatigue]], [[chest pain]], and [[syncope]] are the most common presentations. The symptoms associated with hypertrophic cardiomyopathy are quite variable and range from no [[symptoms]], to the development of [[heart failure]], to the occurrence of [[sudden cardiac death]]. The [[symptoms]] may vary tremendously from individual even within a family. The timing of [[symptom]] onset is quite variable as well and may range from infancy to adulthood. | ||
==Symptoms== | ==Symptoms== | ||
A large number of the patients with hypertrophic cardiomyopathy are [[asymptomatic]] or complain of mild nonspecific [[symptoms]], Patients are often diagnosed by family [[Screening (medicine)|screening]], incidental [[Heart murmur|murmur]] auscultation during routine examination or screening for school athletic events, or via an abnormal [[The electrocardiogram|ECG]]. Nevertheless, in [[symptomatic]] patients, [[left ventricular]] outflow tract gradients and result in symptoms of [[dyspnea]], [[fatigue]], [[chest pain]], and [[syncope]] are the most common presentations.Although most of the patients with hypertrophic cardiomyopathy are [[asymptomatic]], patients may develop one or more of the following [[symptoms]]:<ref name=":0">Maron BJ. Hypertrophic cardiomyopathy. Lancet 1997;350:127–33.</ref><ref name=":1">Maron BJ. Hypertrophic cardiomyopathy. A systematic review. JAMA 2002;287:1308–20.</ref><ref name=":2">Maki S, Ikeda H, Muro A et al. Predictors of sudden cardiac death in | |||
*[[Chest pain]] ( | hypertrophic cardiomyopathy. Am J Cardiol 1998;82:774–8.</ref><ref name=":3">Maron BJ, Casey SA, Poliac LC, Gohman TE, Almquist AK, Aeppli DM. Clinical course of hypertrophic cardiomyopathy in a regional United | ||
States cohort. JAMA 1999;281:650–5.</ref><ref name=":4">Maron BJ, Olivotto I, Bellone P et al. Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 2002;39:301–7.</ref> <ref name=":5">Maron BJ. Hypertrophic cardiomyopathy. A systematic review. JAMA 2002;287:1308–20.</ref><ref name=":6">Maron BJ, Casey SA, Poliac LC, Gohman TE, Almquist AK, Aeppli DM. Clinical course of hypertrophic cardiomyopathy in a regional United States cohort. JAMA 1999;281:650–5.</ref><ref name=":7">Fay WP, Taliercio CP, Ilstrup DM, Tajik AJ, Gersh BJ. Natural history of hypertrophic cardiomyopathy in the elderly. J Am Coll Cardiol 1990;16:821–6.</ref><ref name=":8">Takagi E, Yamakado T, Nakano T. Prognosis of completely asymptomatic adult patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 1999;33:206–11.</ref> | |||
*[[Chest pain]] (also known as [[Angina pectoris|angina]]) | |||
*[[Congestive heart failure]] symptoms including [[exercise intolerance]] and [[dyspnea]]. | |||
*[[Dizziness]] | *[[Dizziness]] | ||
*[[Dyspnea]] ([[shortness of breath]]) | *[[Dyspnea]] ([[shortness of breath]]) which is due to increased stiffness of the [[hypertrophied left ventricle]]. This [[hypertrophy of the left ventricle]] impairs the filling of the [[left ventricle]] and leads to elevated filling pressure in the [[left ventricle]] and the [[left atrium]]. [[Symptoms]] are not closely related to the presence or severity of the [[left ventricular]] outflow tract gradient. | ||
*[[Fainting]] or [[syncope]], especially during exercise | *[[Exercise intolerance]] | ||
*[[Fainting]], [[presyncope]] or frank [[syncope]], especially during exercise | |||
*[[Fatigue]] | *[[Fatigue]] | ||
*[[Heart failure]] (in some patients) | *[[Heart failure]] (in some patients) | ||
| Line 21: | Line 25: | ||
*[[Shortness of breath]] when lying down ([[orthopnea]]) | *[[Shortness of breath]] when lying down ([[orthopnea]]) | ||
*[[Sudden cardiac death]] | *[[Sudden cardiac death]] | ||
==References== | ==References== | ||
Latest revision as of 16:13, 6 February 2020
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Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
A large number of the patients with hypertrophic cardiomyopathy are asymptomatic or complain of mild nonspecific symptoms, Patients are often diagnosed by family screening, incidental murmur auscultation during routine examination or screening for school athletic events, or via an abnormal ECG. Nevertheless, in symptomatic patients, left ventricular outflow tract gradients and result in symptoms of dyspnea, fatigue, chest pain, and syncope are the most common presentations. The symptoms associated with hypertrophic cardiomyopathy are quite variable and range from no symptoms, to the development of heart failure, to the occurrence of sudden cardiac death. The symptoms may vary tremendously from individual even within a family. The timing of symptom onset is quite variable as well and may range from infancy to adulthood.
Symptoms
A large number of the patients with hypertrophic cardiomyopathy are asymptomatic or complain of mild nonspecific symptoms, Patients are often diagnosed by family screening, incidental murmur auscultation during routine examination or screening for school athletic events, or via an abnormal ECG. Nevertheless, in symptomatic patients, left ventricular outflow tract gradients and result in symptoms of dyspnea, fatigue, chest pain, and syncope are the most common presentations.Although most of the patients with hypertrophic cardiomyopathy are asymptomatic, patients may develop one or more of the following symptoms:[1][2][3][4][5] [6][7][8][9]
- Chest pain (also known as angina)
- Congestive heart failure symptoms including exercise intolerance and dyspnea.
- Dizziness
- Dyspnea (shortness of breath) which is due to increased stiffness of the hypertrophied left ventricle. This hypertrophy of the left ventricle impairs the filling of the left ventricle and leads to elevated filling pressure in the left ventricle and the left atrium. Symptoms are not closely related to the presence or severity of the left ventricular outflow tract gradient.
- Exercise intolerance
- Fainting, presyncope or frank syncope, especially during exercise
- Fatigue
- Heart failure (in some patients)
- High blood pressure (hypertension)
- Light-headedness, especially with or after activity or exercise, or when standing up suddenly
- Palpitations or the sensation of feeling the heart beat
- Shortness of breath
- Reduced activity tolerance
- Shortness of breath when lying down (orthopnea)
- Sudden cardiac death
References
- ↑ Maron BJ. Hypertrophic cardiomyopathy. Lancet 1997;350:127–33.
- ↑ Maron BJ. Hypertrophic cardiomyopathy. A systematic review. JAMA 2002;287:1308–20.
- ↑ Maki S, Ikeda H, Muro A et al. Predictors of sudden cardiac death in hypertrophic cardiomyopathy. Am J Cardiol 1998;82:774–8.
- ↑ Maron BJ, Casey SA, Poliac LC, Gohman TE, Almquist AK, Aeppli DM. Clinical course of hypertrophic cardiomyopathy in a regional United States cohort. JAMA 1999;281:650–5.
- ↑ Maron BJ, Olivotto I, Bellone P et al. Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 2002;39:301–7.
- ↑ Maron BJ. Hypertrophic cardiomyopathy. A systematic review. JAMA 2002;287:1308–20.
- ↑ Maron BJ, Casey SA, Poliac LC, Gohman TE, Almquist AK, Aeppli DM. Clinical course of hypertrophic cardiomyopathy in a regional United States cohort. JAMA 1999;281:650–5.
- ↑ Fay WP, Taliercio CP, Ilstrup DM, Tajik AJ, Gersh BJ. Natural history of hypertrophic cardiomyopathy in the elderly. J Am Coll Cardiol 1990;16:821–6.
- ↑ Takagi E, Yamakado T, Nakano T. Prognosis of completely asymptomatic adult patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 1999;33:206–11.