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Hypertrophic Cardiomyopathy (HCM) discussing pathophysiology, diagnosis and management

Abstract

Elvin Daniel

Hypertrophic Cardiomyopathy (HCM) / Hypertrophic obstructive Cardiomyopathy (HOCM) /Idiopathic hypertrophic sub-aortic stenosis (IHSS) is the most common heritable cardiomyopathy affecting approx 1 in 500 people. HCM is a diagnosis of exclusion; secondary causes of left ventricular hypertrophy (LVH) such as systemic hypertension, valvular and subvalvular aortic stenosis, and infiltrative cardiomyopathies must be ruled out. Patient presentation is phenotypically diverse, ranging from asymptomatic to heart failure or sudden cardiac death (SCD). Left ventricular hypertrophy and abnormal ventricular configuration result in dynamic left ventricular outflow obstruction (gradient >30mmHg) in most patients. The goal of therapeutic interventions is largely to reduce dynamic obstruction, with treatment modalities spanning lifestyle modifications, pharmacotherapies, and septal reduction therapies. Our center at New Delhi has done over 30 successful cases of HCM.