INTRODUCTIONHypertrophic cardiomyopathy (HCM)HCM is the commonest familial heart disease, with a prevalence of up to 0.2% . HCM is characterized by left ventricular hypertrophy (LVH) in the absence of another disease process accounting for the magnitude of hypertrophy present . Many patients remain asymptomatic for decades; however, patients may present with cardiac arrhythmias or with debilitating symptoms including chest pain, dyspnea, dizziness, and fatigue . Obstruction to LV systolic ejection is frequently detected in patients with symptomatic HCM and contributes to symptoms and prognosis. As such, the presence and magnitude of obstruction dominates clinical decision making .In the “classical” variant of obstructive HCM, the closed mitral valve progressively moves toward the hypertrophied interventricular septum in systole [systolic anterior motion (SAM)]. This results in a dynamic LV outflow tract obstruction (LVOTO) and secondary mitral regurgitation. In a less common obstructive HCM variant (up to 10% in some series) , dynamic intracavity obstruction develops as a consequence of hypertrophy and apparent hypercontractility at the level of the papillary muscles causing LV mid‐cavity obstruction (LVMCO) .LVMCO is not associated with mitral regurgitation or SAM and is often missed at echocardiography, the distal chamber being outside the sector of two‐dimensional imaging due to
Catheterization and Cardiovascular Interventions – Wiley
Published: Jan 1, 2018
Keywords: ; ; ;
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