Hypertrophic cardiomyopathy is characterized by a significant thickening and an increase in the volume (hypertrophy) wall of the left ventricle of the heart, while its inner cavity does not expand. In most cases, more and thicker interventricular septum.
The frequency of hypertrophic cardiomyopathy was 0.2%. Get sick more often young people. The disease progresses steadily. In hypertrophic cardiomyopathy there is the greatest threat of sudden death. Mortality in this disease 2-4%. We prove the hereditary nature of hypertrophic cardiomyopathy. This so-called "family hypertrophic cardiomyopathy." But there are times when you can not prove the hereditary nature. When the disease is not found in close relatives of the sick, it is believed that there was a mutation of genes encoding proteins of the heart muscle.
The heart muscle is thickened in hypertrophic cardiomyopathy and less extensible. The myocardium may be uniformly thickened or mainly in any departments. Depends on this version of the disease:
If the heart muscle hypertrophies to a greater extent in the area under the discharge of the aorta, in this case can be narrowed exit from the left ventricle. This is accompanied by a thickening of the heart, which consist of valves, and disturbed function of the mitral and aortic valves. Most often this occurs at irregular thickening of the interventricular septum.
The variant of an asymmetric thickening of the wall without breaking the valvular and narrow exit from the left ventricle.
Apical hypertrophic cardiomyopathy occurs when the heart muscle increases only at the apex of the heart.
The symmetric hypertrophic cardiomyopathy with a circular left ventricular hypertrophy.
Most hypertrophic cardiomyopathy ill young people. The disease occurs very diverse. In some patients, a long time there are no complaints. The other from the beginning in a serious condition and the high risk of sudden death. The most common manifestation of cardiomyopathy, heart pain of various kinds of stabbing and aching to typical angina attack. Most patients with hypertrophic cardiomyopathy, angina occurs. This is because in a compressed hypertrophy, coronary vessels, and enlarged heart muscle needs more oxygen and nutrients. There is a mismatch between myocardial oxygen demand and delivery.
Very frequent manifestation - cardiac rhythm. Conduction system of the heart is squeezed, the normal distribution of the electric pulse is broken and there are a variety of rhythm disturbances of heart contractions. Patients complain of shortages in the heart, heartbeat, heart failure.
Because arrhythmias and reducing cerebral blood flow occur fainting. In some cases this may be the only faint throughout life, others may have several fainting every day.
Sometimes the first symptom of the disease may become short of breath.
On examination, the patient reveals the expansion of the boundaries of the heart, systolic murmur over the heart. On radiographs are an increase in left ventricular serdtsa.Na are specific changes in the electrocardiogram, which can make a diagnosis of hypertrophic cardiomyopathy. But the main method of diagnosis is the echocardiogram. With the help reveal thickening of the heart muscle, thickening of the interventricular septum, decreased motor activity of the myocardium. Sometimes a biopsy of the heart muscle (myocardium slices of the study under a microscope).
Treatment of hypertrophic cardiomyopathy.
Treatment is aimed at reducing the symptoms of the cardiovascular system. Used beta-blockers and verapamil. These drugs are used in the treatment of the disease emerged, and the detection of hypertrophic cardiomyopathy with asymptomatic course (unless there were complaints). The ineffectiveness of medical treatment is carried out surgery to remove part of the hypertrophied heart muscle. Prognosis of hypertrophic cardiomyopathy favorable compared with other types of cardiomyopathies. The disease can occur for decades. The patient is able to work for a long time. There are even pregnancy and childbirth in women with hypertrophic cardiomyopathy. The patient must remember that it is contraindicated considerable physical exertion.