Clinical profile of hypertrophic Cardiomyopathy
Journal Title: Medpulse International Journal of Medicine - Year 2018, Vol 5, Issue 1
Abstract
Background: Hypertrophic cardiomyopathy (HCM) is defined by increased left ventricular (LV) wall thickness (R15 mm in one or more LV myocardial segments), that cannot be explained by abnormal loading conditions. The clinical spectrum of HCM is complex and includes a variety of phenotypes, which leads to different types of manifestations. Although most of the patients are asymptomatic, up to 25% will develop symptoms or risk of arrhythmias and sudden cardiac death (SCD). Aims and Objectives: To study the clinical profile of patients of Hypertrophic Cardiomyopathy reporting to a tertiary care centre situated in north Karnataka catering largely to a rural population. Material and Methods: The present study was conducted in the Department of Medicine of Bidar Institute of Medical Sciences., Bidar. For the purpose of study total 105 cases of Hypertrophic Cardiomyopathy reporting to the department of Medicine were selected. The diagnosis of HCM was based on 2D Echocardiographic (2D Echo) and ECG documentation. The cases include newly diagnosed and known cases also. After receiving approval from institutional ethical committee, the study was conducted. Informed written consent from all the selected study patients was obtained.Detail history of each patient was recorded on a prestructured proforma. Details regarding age, sex, address and socioeconomic status were noted. Information regarding the presenting complaints, any significant past and family history was also recorded. Complete general and systemic examination was performed in all the patients and the findings were recorded. Results: Mean age of patients was 49.79± 14.66years. Majority (73.33%) of the patients were male. The most common presenting complaint was angina followed by dyspnea on exertion. Past history of hypertrophic cardiomyopathy was reported by 41.90% patients. Family history of hypertrophic cardiomyopathy was observed in 9.52%. Prominent JVP ‘a’ wave was noted in 23.81% patients in the study.S3 heart sound was heard in 6.67% patients where as S4 was heard in 79.05% patients. Left ventricular outflow tract murmur was present in 54.29% patients and mitral regurgitation was observed in 17.14% patients of HCM. On 2D Echo inter ventricular septum thickness and posterior wall thickness in diastole was significantly more in apical HCM as compared to other HCM variants. Left atrium size was also significantly increased in HOCM (38.60±7.94). Mean left ventricular diastolic dysfunction was observed in higher grades in HCM andapical HCM as compared to HOCM and the difference observed was also statistically significant. The mean left ventricular ejection fraction was lowest in HCM and was statistically significant as compared to apical HCM and HOCM. Conclusion: Hypertrophic obstructive cardiomyopathy (HOCM) was the commonest cardiomyopathy in the present study. Cardiomyopathy presented with wide variation in clinical features with angina and dyspnea on exertion as the most common presenting complaint. Prominent ‘a’ wave of JVP and audible fourth heart sound with Left ventricular outflow tract murmur are the common clinical features associated with HCM. 2D Echo examination in HCM was the most important investigation for diagnosis and also for cardiac functional assessment.
Authors and Affiliations
Rajshekhar I Koujalgi
Keywords
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- EP ID EP464399
- DOI 10.26611/1021513
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