39 Hypertrophic Cardiomyopathy

Pathogenesis

  • expression result in varied severity and location

  • beta myosin heavy chain
  • myosin binding protein

Histology

  • right: normal, straight, organized
  • left: HCM, swirly

Symptoms

  • 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

  • aortic stenosis: fixed obstruction
  • HCM: dynamic obstruction, as ventricle contracts, obstruction worse

Associations

  • lots of sugar/fuel to heart, thickened heart

Other Hypertrophies

  • HTN: thickened in response to high BP
  • atheletes: heart in good shape