Do you know the symptoms or treatment of hypertrophic cardiomyopathy?

 

Hypertrophic cardiomyopathy is a disease in which the walls of the left and right ventricles become thick and hard without a clear cause of hypertrophy. There are cases of asymptomatic symptoms, but there is also a risk of shortness of breath, chest compression, and sudden death. Treatment for hypertrophic cardiomyopathy varies, including the use of internal medicine and surgery. This time, we will explain the symptoms of hypertrophic cardiomyopathy, test and diagnosis, and treatment.

What is hypertrophic cardiomyopathy?

What kind of disease is hypertrophic cardiomyopathy?

Hypertrophic cardiomyopathy is a disease in which the left and right ventricle walls become thick and firm, causing heart dysfunction, even though there is no suspicion of hypertension or secondary cardiomyopathy, with a core of more than 15mm (more than 13mm in the family history of hypertension).

Hypertrophic cardiomyopathy can also cause self-awareness, such as shortness of breath, chest pain, palpitations, or fainting, and in the worst case, sudden death. Most hypertrophic cardiomyopathy is caused by abnormalities in genes inherited from parents.

If the doctor suspects this disease due to physical findings, he or she will confirm the diagnosis through a cardiac chocolate test or MRI test. Treatment for hypertrophic cardiomyopathy is diverse, including the use of internal medicine and surgery that lowers heart contraction, and restrictions on exercise, drinking, and pregnancy may be necessary to avoid worsening symptoms.

According to the results of the screening study by echocardiography, 374 people per 100,000 people, 3:2 compared to men and women, and both men and women have peaks at the age of 60 to 69.

symptoms of hypertrophic cardiomyopathy

Symptoms of hypertrophic cardiomyopathy include chest and brain symptoms. Chest symptoms include chest pain, shortness of breath, and palpitations. Brain symptoms are caused by the effects of enlarged ventricles or arrhythmia due to dark steam, dizziness, and fainting in front of the eyes. These symptoms are likely to appear due to sudden changes in temperature, such as sudden occurrences, drinking, and moving from cold to warm places.

There are cases of asymptomatic symptoms, but in critical cases, it can cause fainting or sudden death in relation to decreased blood supply and arrhythmia in the ventricle. If you are diagnosed with hypertrophic cardiomyopathy by a doctor, careful observation is required.

Symptoms usually occur at the age of 20 to 40, and first of all, fainting, chest pain, shortness of breath, and heart palpitations occur during activities. Fainting usually happens suddenly without any signs of alertness, and even when fainting or sudden death is the first sign of sudden death.

Causes of hypertrophic cardiomyopathy

In hypertrophic cardiomyopathy, the space inside the ventricle decreases due to abnormal thickening of the myocardium, reducing the amount of blood originally to be accumulated in the ventricle. It is a disease that cannot send necessary blood to the whole body because the amount of blood that can be sent to the whole body decreases at a single heart rate.

The cause of the thickening of the heart muscle is due to naturally occurring genetic mutations or abnormalities in genes inherited from parents. About half of hypertrophic cardiomyopathy can be seen in the family of autosomal dominant genes, and more than 900 mutations have been identified by more than 16 genes, including myofascial genes such as Troponin T. The progress or symptoms vary depending on the gene that causes it. However, it can be seen that the cause of hypertrophic cardiomyopathy is not only family history, but also genetic abnormalities cannot be specified.

Examination and diagnosis of hypertrophic cardiomyopathy

In the diagnosis of hypertrophic cardiomyopathy, symptoms, physical examination, echocardiography, electrocardiogram, chest X-ray, and MRI are performed. Heart sounds or heart murmur that sound like a stethoscope are effective in diagnosing. Echocardiography is the best way to determine your diagnosis, but more detailed information can be obtained by conducting an MRI scan.

Cardiac catheterization inserts the catheter from the back of the arm into the heart. Although it is a heavy test for the body, it is conducted to measure blood pressure in the heart if surgery is being considered. In addition, hypertrophic cardiomyopathy is a major cause of genetic variation, so genetic testing is also performed.

an echocardiogram

Echocardiography shows that the left barrier is thick. If there is stenosis with a narrow sedentary outflow through the outlet of the left ventricle, abnormal movement of the mitral valve or an increase in blood flow rate can be seen.

an electrocardiogram test

An electrocardiogram can identify waveform abnormalities caused by thickening of the ventricles. In hypertrophic cardiomyopathy patients, some abnormalities are recognized in 75 to 96%, and ST-T changes, abnormal Q waves, negative T waves, and high potential are observed due to the influence of enlarged ventricles.

a cardiac catheterization, myocardial biopsy

Cardiac catheterization is performed to check blood circulation dynamics in more detail. During cardiac catheterization, cells from the heart are collected and myocardial biopsy is performed to diagnose hypertrophic cardiomyopathy more accurately.

treatment of hypertrophic cardiomyopathy

For hypertrophic cardiomyopathy treatment, the treatment is selected according to symptoms or severity with the aim of reducing resistance when blood flows into the heart. It is largely divided into drug therapy and invasive treatment (non-drug treatment), but if there are no symptoms of self-awareness and no previous history of arrhythmia, it is also possible to follow-up with no medication.

a treatment for hypertrophic cardiomyopathy

The main treatment is administered alone or in combination with a beta blocker and a calcium antagonist called verapamil. Both drugs reduce myocardial contraction, resulting in more blood flowing into the heart. In addition, blood flow from the heart is smooth when blood flow is blocked by the thickened myocardium. In addition, it also has a function to slow down the atrium, which increases the time for blood to flow to the heart. Amiodarone is also used for the treatment of some pyramids and arrhythmia, which have an effect of weakening the contraction of the heart.

myocardial resection

Only when the symptoms have not improved with medication, myocardial resection is performed to remove part of the thickened myocardium to improve blood flow from the heart. Cardiomyectomy can be expected to reduce symptoms, but the risk of death is not lowered.

catheterization

There are three methods of catheter ablation: cauterization, freezing, and chemical methods, and chemical methods become relatively new methods in alcohol ablation. Alcohol albrations limit and destroy parts of the myocardium by injecting alcohol to improve blood flow in the heart.

This treatment is available during cardiac catheterization. High concentrations of ethanol are injected into the coronary artery flowing into the thick septum myocardium, which causes stenosis by sedentary outflow, to locally necrosis to improve stenosis by sedentary outflow.

In catheter inflation, there is also a way to improve symptoms by cauterizing or freezing abnormalities using catheters.

an implantable defibrillator

In particular, people with severe thickening in the septum that separates the heart cavity have a high risk of sudden death, so it can be expected to be effective by reducing the front intersection of the outflow path using the Humman type defibrillator.

arrangement

Hypertrophic cardiomyopathy may be asymptomatic, but in serious symptoms, it can cause fainting or sudden death, so careful follow-up is required if diagnosed as hypertrophic cardiomyopathy. In addition, in your daily life, exercise, drinking, and pregnancy may be restricted to avoid worsening symptoms, so please pay attention to your life according to your doctor's instructions.