اعتلال عضلة القلب الضخامي

Definition

Hypertrophic cardiomyopathy is a mostly inherited disease in which the left ventricular wall thickens without a cause such as hypertension, and the thickened septum may obstruct outflow into the aorta.

Why it matters

A leading cause of sudden death in young athletes.

Symptoms

• Breathlessness and chest pain
• Palpitations and syncope, especially on exertion
• Or none until the first event

Signs

A systolic murmur that increases with Valsalva and standing and decreases with squatting.

Diagnosis

Echocardiography, cardiac MRI and screening of family members.

Treatment

• Beta-blockers or certain calcium channel blockers to lengthen filling time
• An implantable cardioverter-defibrillator for those at risk of sudden death
• Septal reduction (surgical or catheter) or newer drugs as indicated

Nursing care

• Teach good hydration and avoidance of dehydration
• Avoid intense competitive sport as advised by the cardiologist
• Avoid diuretics, nitrates and vasodilators unless supervised

Exam point

Anything that reduces ventricular filling (dehydration, vasodilators, nitroglycerin) worsens obstruction and symptoms.