Hypertrophic cardiomyopathy history and symptoms
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Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1] 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.