39 Hypertrophic Cardiomyopathy

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Pathogenesis

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• expression result in varied severity and location

• beta myosin heavy chain

• myosin binding protein

Histology

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• right: normal, straight, organized

• left: HCM, swirly

Symptoms

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• myocardium of LV grows not due to normal physiologic stimulus

• due to no obvious trigger

• as ventricle contracts, septum gets even thicker

• HF: blood can't get out

• chest pain: LVEDP rises, low coronary blood flow

• exercise: even more contraction

• high blood velocity tugs on anterior leaflet of MV

Murmur

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• aortic stenosis: fixed obstruction

• HCM: dynamic obstruction, as ventricle contracts, obstruction worse

Associations

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• lots of sugar/fuel to heart, thickened heart

Other Hypertrophies

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• HTN: thickened in response to high BP

• atheletes: heart in good shape