Hypertrophic Cardiomyopathy (HCM)

25 Jun


-only about 50% of patients will have positive family history

-average age of diagnosis is 30-40 years -> not always a teenager or young adult!

-clinical features: syncope, chest pain, palpitations, dyspnea

systolic murmur at apex or LLSB

  • increases with valsalva and standing
  • decreases with trendelenburg and squatting

-ECG abnormalities present >85% of the time

            high left ventricular voltage, left atrial enlargement

            tall R wave in V1 (mimics posterior MI)

            deep, narrow Q-waves in inferior, lateral leads

-definitive diagnosis Doppler ECHO

-treatment: beta blockers, calcium channel blockers; these patients should be urgently referred to cardiology and be counseled to avoid strenuous activity

Source: lifeinthefastlane.com, Mattu A, Brady W. ECGs for the Emergency Physician 2, BMJ Books 2008.; picture

Submitted by K Estes.


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