Hypertrophic cardiomyopathy history and symptoms: Difference between revisions
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*Some patients have no symptoms. They may not even realize they have the condition until it is found during a routine medical exam | *Some patients have no symptoms. They may not even realize they have the condition until it is found during a routine medical exam | ||
*[[Chest pain]] | *[[Chest pain]] (sometimes known as ''[[Angina pectoris|angina]]'') | ||
*[[Dizziness]] | *[[Dizziness]] | ||
*[[Fainting]], especially during exercise | *[[Dyspnea]] ([[shortness of breath]]) | ||
*[[Fainting]] or [[syncope]], especially during exercise | |||
*[[Fatigue]] | |||
*[[Heart failure]] (in some patients) | *[[Heart failure]] (in some patients) | ||
*[[High blood pressure]] ([[hypertension]]) | *[[High blood pressure]] ([[hypertension]]) | ||
*[[Light-headedness]], especially with or after activity or exercise, or when standing up suddenly | *[[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]] | *[[Shortness of breath]] | ||
*[[Reduced activity tolerance]] | *[[Reduced activity tolerance]] | ||
*[[Shortness of breath]] when lying down ([[orthopnea]]) | *[[Shortness of breath]] when lying down ([[orthopnea]]) | ||
*[[Sudden cardiac death]] | |||
==Specific Symptoms== | |||
[[Dyspnea]] is largely due to increased stiffness of the [[left ventricle]], which impairs filling of the ventricles and leads to elevated pressure in the left ventricle and left atrium. Symptoms are not closely related to the presence or severity of an outflow tract gradient | |||
<ref name="Braunwauld 2005">Braunwauld E. The Cardiomyopathies, in Braunwald's ''Heart Disease'', 7th ed, D Zipes, et al (eds). Philadelphia, Saunders, 2005</ref>. Oftentimes, symptoms mimic those of [[congestive heart failure]] (esp. activity intolerance & dyspnea), but it must be noted that treatment is very different. To treat with diuretics (a mainstay of [[CHF]] treatment) will exacerbate symptoms in hypertrophic cardiomyopathy by decreasing ventricular volume and increasing outflow resistance. | |||
Risk factors for sudden death in individuals with HCM include a young age at first diagnosis (age < 30 years), an episode of aborted sudden death, a family history of HCM with sudden death of relatives, specific mutations in the genes encoding for troponin T and myosin, sustained [[supraventricular tachycardia|supraventricular]] or [[ventricular tachycardia]], recurrent [[syncope]], ventricular septal wall thickness over 3 cm, hypotensive response to exercise, [[syncope]] (especially in children), and bradyarrhythmias (slow rhythms of the heart)<ref name="Maron, Cecchi et al 1994">Maron BJ, Cecchi F, McKenna WJ. Risk factors and stratification for sudden cardiac death in patients with hypertrophic cardiomyopathy. ''[[British Heart Journal|Br Heart J]]''. 1994 Dec; '''72'''(6 Suppl):S13–8. ([http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7873317 Medline abstract]) and the Task Force on Sudden Cardiac Death of the European Society of Cardiology [http://www.guideline.gov/summary/summary.aspx?doc_id=2977 link] Note: Guideline withdraw</ref> | |||
==References== | ==References== | ||
Revision as of 00:21, 13 August 2011
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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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.
What are the symptoms of Hypertrophic cardiomyopathy?
- Some patients have no symptoms. They may not even realize they have the condition until it is found during a routine medical exam
- Chest pain (sometimes known as angina)
- Dizziness
- Dyspnea (shortness of breath)
- Fainting or 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
Specific Symptoms
Dyspnea is largely due to increased stiffness of the left ventricle, which impairs filling of the ventricles and leads to elevated pressure in the left ventricle and left atrium. Symptoms are not closely related to the presence or severity of an outflow tract gradient [1]. Oftentimes, symptoms mimic those of congestive heart failure (esp. activity intolerance & dyspnea), but it must be noted that treatment is very different. To treat with diuretics (a mainstay of CHF treatment) will exacerbate symptoms in hypertrophic cardiomyopathy by decreasing ventricular volume and increasing outflow resistance.
Risk factors for sudden death in individuals with HCM include a young age at first diagnosis (age < 30 years), an episode of aborted sudden death, a family history of HCM with sudden death of relatives, specific mutations in the genes encoding for troponin T and myosin, sustained supraventricular or ventricular tachycardia, recurrent syncope, ventricular septal wall thickness over 3 cm, hypotensive response to exercise, syncope (especially in children), and bradyarrhythmias (slow rhythms of the heart)[2]
References
- ↑ Braunwauld E. The Cardiomyopathies, in Braunwald's Heart Disease, 7th ed, D Zipes, et al (eds). Philadelphia, Saunders, 2005
- ↑ Maron BJ, Cecchi F, McKenna WJ. Risk factors and stratification for sudden cardiac death in patients with hypertrophic cardiomyopathy. Br Heart J. 1994 Dec; 72(6 Suppl):S13–8. (Medline abstract) and the Task Force on Sudden Cardiac Death of the European Society of Cardiology link Note: Guideline withdraw