Hypertrophic cardiomyopathy echocardiography

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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Echocardiography is the imaging modality of choice in the diagnosis of hypertrophic cardiomyopathy. Classically there is a small left ventricular cavity with hypertrophy out of proportion to any underlying condition that would cause LVH. The hypertrophy is often asymmetric.

Frequency of Hypertrophy

While LVH is often present, not all carriers with HCM demonstrate left ventricular hypertrophy.

Diagnostic Fefatures

  • Left ventricular hypertrophy (LVH) most often in an asymmetric distribution,
  • Thickening of the left ventricular wall in the absence of cavitary dilation and the presence of hyperdynamic activity (in fact there may be systolic cavity obliteration or near obliteration)
  • Absnece of any other cause of left ventricular hypertrophy such as aortic stenosis or hypertension

Left Ventricular Wall Thickness

  • The traditional definition requires a wall thickness > 15 mm.
  • Borderline wall thicknesses of 13-14 mm must be distinguished from extreme variants of athletes heart
  • There are some genetic variants that yield a normal wall thickness [1].
  • Among children < 13 years of age, [[LVH}} is often absent.

References

  1. Niimura H, Bachinski LL, Sangwatanaroj S et al. Mutations in the gene for cardiac myosin-binding protein C and late-onset familial hypertrophic cardiomyopathy. N Engl J Med 1998;338:1248–57.