Individuals with no or only minor symptoms are often diagnosed as a result of family screening, detection of a murmur during routine examination, or the identification of an abnormal ECG. Any individual suspected of having HCM should undergo a comprehensive cardiac history and physical examination and an electrocardiogram (ECG). ECG testing is the most sensitive routinely performed diagnostic test for HCM, but the ECG abnormalities are not specific to HCM and should prompt further diagnostic evaluation. Left ventricular hypertrophy is nearly universal in symptomatic patients; however, individuals with localized hypertrophy may present with an entirely normal ECG. Typically, the ECG is deemed …show more content…
The echocardiogram of an individual with HCM can reveal asymmetric left ventricular hypertrophy, systolic anterior motion of the mitral valve, early closing followed by reopening of the aortic valve, a small and hypercontractile left ventricle, and delayed relaxation and filling of the left ventricle during diastole. A clinical diagnosis of HCM is confirmed when unexplained increased left ventricular wall thickness is greater than or equal to 15mm anywhere on the left ventricular wall. A thickness of greater than or equal to 13mm of wall thickness may also be considered diagnostic when an individual has family history of …show more content…
Individuals with ECG and echocardiographic evidence of HCM should also undergo portable ECG monitoring and exercise stress testing for additional prognostic information and risk stratification. HCM must be distinguished from acquired causes of hypertrophy including hypertension, aortic stenosis, and increased wall thickness developed by highly trained athletes.
Treatment
There is no cure for hypertrophic cardiomyopathy thus treatment is focused on relieving the symptoms and decrease the risks associated with HCM. Treatment depends upon the individual’s situation but may focus on reducing the symptoms of heart failure and chest pain, removing excess muscle from the intraventricular septum in order to improve blood flow and lower the pressures in the heart, and treat abnormal heart rhythms and/or reduce the risk of sudden death.
Possible medication