Hypertrophic cardiomyopathy: Difference between revisions
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==Background== | ==Background== | ||
Genetically-linked (AD) hypertrophy of cardiac muscle - can but does not always cause outflow obstruction | Genetically-linked (AD) hypertrophy of cardiac muscle - can but does not always cause outflow obstruction | ||
==Diagnosis== | ==Diagnosis== | ||
#Sx: Syncope or sudden death most common. Also CP, SOB, dizzyness, palpitations, or CHF | |||
#PE: if + syst murmur, will increase with valsalva | |||
#EKG: Nonspecific/normal. Or, high voltage/LVH, deep narrow Q waves in 1, avL, V5, V6 = "daggers of death" | |||
==Work-Up== | |||
#EKG | |||
#CXR | |||
#ECHO | |||
==Treatment== | |||
Myomectomy | Myomectomy | ||
===Decompensated!=== | ===Decompensated!=== | ||
Presents as hypotensive CHF | |||
#Preserve preload | |||
##careful hydration | |||
##avoid high airway pressures with mechanical ventilation (small TV with high RR) | |||
#Limit tachycardia | |||
##beta blockers | |||
#Avoid vasodilators (no nitrates) | |||
#Maintain sinus rythm (i.e. cardiovert A. fib) | |||
#Increase afterload (hypotenisve only) | |||
##phenlephrine | |||
==Source== | |||
Adapted from ....Rosen, Mattu (lecture) | Adapted from ....Rosen, Mattu (lecture) | ||
[[Category:Cards]] | [[Category:Cards]] | ||
Revision as of 17:28, 12 March 2011
Background
Genetically-linked (AD) hypertrophy of cardiac muscle - can but does not always cause outflow obstruction
Diagnosis
- Sx: Syncope or sudden death most common. Also CP, SOB, dizzyness, palpitations, or CHF
- PE: if + syst murmur, will increase with valsalva
- EKG: Nonspecific/normal. Or, high voltage/LVH, deep narrow Q waves in 1, avL, V5, V6 = "daggers of death"
Work-Up
- EKG
- CXR
- ECHO
Treatment
Myomectomy
Decompensated!
Presents as hypotensive CHF
- Preserve preload
- careful hydration
- avoid high airway pressures with mechanical ventilation (small TV with high RR)
- Limit tachycardia
- beta blockers
- Avoid vasodilators (no nitrates)
- Maintain sinus rythm (i.e. cardiovert A. fib)
- Increase afterload (hypotenisve only)
- phenlephrine
Source
Adapted from ....Rosen, Mattu (lecture)