The disease, which thickens the wall of the left, and in the more rare cases of the right ventricle of the heart, is called hypertrophic cardiomyopathy (HCMC). In this disease, thickening in very rare cases occurs symmetrically, and therefore the interventricular septum is often damaged.
It is believed that this is a disease of athletes - it is because of increased physical exertion that hypertrophy occurs. We already know several cases when athletes died on sports grounds because of hypertrophic cardiomyopathy - Hungarian football player Miklos Feher and American athlete Jesse Marunde.
In this disease, the muscle fibers in the myocardium have a chaotic location, which is associated with a gene mutation.
Forms of hypertrophic cardiomyopathy
Today, doctors identify 3 forms of hypertrophic cardiomyopathy:
- Basal obstruction - the gradient at rest is greater than or equal to 30 mm Hg. Art.
- Labile obstruction - spontaneous fluctuations of the intraventricular gradient are observed.
- Latent obstruction - a gradient in a calm state less than 30 mm Hg. Art.
Obstructive hypertrophic cardiomyopathy corresponds to these three forms of the disease, while a truly non-obstructive form is characterized by a stenosis gradient less than 30 mm Hg. Art. in a calm and provoked state.
Symptoms of hypertrophic cardiomyopathy
Symptomatic of hypertrophic cardiomyopathy may be absent - about 30% of patients do not make any complaints, in which case sudden death may be the only manifestation of the disease. In a special risk zone are young patients who do not observe complaints, except for heart rhythm disturbances.
For this disease is characterized by the so-called small-emission syndrome - in this case, fainting occurs, shortness of breath and dizziness, and angina attacks occur.
Also, with hypertrophic cardiomyopathy, there may be manifestations of left ventricular heart failure, which can develop into congestive heart failure.
Failures in the rhythm of the heart can lead to fainting . Often these are ventricular extrasystoles and paroxysms of ventricular tachycardia.
In very rare cases, patients may have infectious endocarditis and thromboembolism.
Diagnosis of hypertrophic cardiomyopathy
Unlike other types of cardiomyopathy, the hypertrophic form is diagnosed much easier due to the established criterion: for a diagnosis to be approved, the myocardial thickening should be greater than or equal to 1.5 cm along with the presence of left ventricular dysfunction (impaired relaxation).
When examined, the patient is found to expand the border of the heart to the left, and when obstructed, noise is heard (systolic rhomboid).
Among the additional methods of studying this pathology are the following:
- electrocardiography - with it they detect an increase in the left atrium;
- Echocardiography is the main method that helps to find the localization of hypertrophy;
- ECG monitoring - determines the rhythm disturbance;
- magnetic resonance imaging - used as a refinement method;
- genetic diagnosis is one of the most important methods for assessing the disease prognosis.
Treatment of hypertrophic cardiomyopathy
Diagnosis and treatment of hypertrophic cardiomyopathy are closely interrelated to prevent a fatal outcome. After evaluating the prognosis of the course of the disease, if there is a possibility of a lethal outcome, complex treatment is performed. If there is no death threat, and the symptoms are not
For treatment it is very important to limit physical activity, and also to take drugs with a negative ionotropic effect. This category includes beta-blockers and calcium antagonists. They are selected individually, and given that the reception is carried out for a long time (up to lifelong reception), today doctors are trying to prescribe medications with minimal side effects. Formerly Anaprilin was used, and today there are many analogues of the new generation.
Also, antiarrhythmic medications and antibiotics are used in the treatment in case of an infectious component of pathology.