Hypertrophic Cardiomyopathy: A Case Study

FIG : NORMAL HEART FIG : HYPERTROPHIC HEART

(Hypertrophic cardiomyopathy,Cleveland clinic)

Above figure in the left shows physiology of the normal heart while the right one shows physiology of hypertrophic heart having leaky mitral valve, thickened septum and narrowed outflow tract.

Symptoms of hypertrophic cardiomyopathy: (Marian Ali .,2010)

• Arrhythmias: This condition mainly occurs when heart rhythms of the patient are irregular due to improper flow of blood from the heart to rest of the body. This could further lead to cardiac failure along with sudden death of the patient.

• Syncope: It does not occur frequently but usually in patients having left ventricular outflow

When both left ventricular hypertrophy and right atrial enlargement is present, this a strong indication of HCM.

• Left axis deviation

• Deeply inverted T waves

(Gersh BJ, et al. 2011) Fig : ECG of Left ventricular hypertrophy Fig : ECG of normal heart.

( uptodate, 2014)

The above ECG figure in left shows ST-T wave abnormalities which is the indication of left ventricular hypertrophy where as the ECG figure in the right shows the normal echocardiogram having normal sinus rhythm at a rate of 75 beats/min, PR interval of 0.14 sec, a QRS interval of 0.10 sec, and a QRS axis of approx. 75°.

Echocardiography

Generally there are two types of echocardiography is performed for hypertrophic cardiomyopathy

Transthoracic echocardiogram: transducer is placed over the chest to aim the ultrasound beam to heart ( HCM, MAYO CLINIC)

Transesophageal echocardiogram: transducer is to the throat with the help of flexible tube and ultrasound is produced. This is rarely done, performed only if it is difficult to get clear image of heart by standard echocardiogram (HCM, MAYO CLINIC) Fig : echocardiogram showing HCM

(Maron BJ, et al,

III. Familial and senile amyloid heart disease : familial amyloid heart disease is inherited and is caused due to overproduction of protein transthyretin ,which is produced in the liver while senile amyloid heart disease is caused due to deposits of normal protein transthyretin in heart tissues (Cleveland clinic.,2014).

B ) HEMOCHROMATOSIS :

It is also known as bronze diabetes occurs when exceesive loads of iron get deposited in sarcoplasmic reticulum of organs. This can lead to excessive fibrosis and cell death and may also result in dilated or restrictive cardioyopathy (Sisakian H.,2014).

C ) SARCOIDOSIS : It is a disease resulting in granulomas formation in myocardium that cause restrictive cardiomyopathy and mostly leads to dilated cardiomyopathy ,also it can be found in patients with splenomegaly, skin rashes or having cardiomyopathy (Cleveland clinic.,2014).

Diagnosis of restrictive cardiomyopathy

It is one of the rarest cardiomyopathy. It is difficult to diagnose in the early stage due to lack of symptoms. Diagnosis of restrictive cardiomyopathy is based on the

1. Examination of patient

2. Test.

Physical exam: A physical may show

• Enlarged or bulging neck veins

• Enlarged