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