Hypertrophic cardiomyopathy

Background

Genetically-linked (AD) hypertrophy of cardiac muscle - can but does not always cause outflow obstruction

Sx: Syncope or sudden death most common. Also CP, SOB, dizzyness, palpitations, or CHF

PE: if + syst murmur, will increase with valsalva

EKG: Nonspecific/normal. Or, high voltage/LVH, deep narrow Q waves in 1, avL, V5, V6 = "daggers of death" ==Work-Up==

EKGCXRECHO ==Treatment==

Myomectomy

1) Preserve preload

    -careful hydration

    -avoid high airway pressures with mechanical ventilation (small TV with high RR)

2) Limit tachycardia

    -beta blockers

3) Avoid vasodilators (no nitrates)

4) Maintain sinus rythm (i.e. cardiovert A. fib)

5) Increase afterload (hypotenisve only) -phenlephrine

==Source==

Adapted from ....Rosen, Mattu (lecture)

Authors: