Hypertrophic cardiomyopathy - signs and symptoms, causes, pathophysiology, treatment

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"Hypertrophic cardiomyopathy (HCM) is the most common primary cardiomyopathy, with a prevalence of 1:500 persons.It is defined as left ventricular hypertrophy without chamber dilation. It is caused by autosomal dominant mutations of genes that code for sarcomere proteins. The most common mutation is of the myosin heavy chain. Secondary causes of hypertrophic cardiomyopathy is chronic hypertension and aortic stenosis.
In Hypertrophic cardiomyopathy there are two main types of disease. The classic obstructive type which is characterised by ventricular hypertrophy as well as interventricular septal hypertrophy. The second type is the non obstructive type which is just your basic Hypertrophy of the ventricles meaning increased ventricle wall thickness. In both obstructive and non obstructive cases the cardiac output is reduced (more so during exercise) causing dyspnoea, presyncope, angina and increasing risk of arrhythmia.
On examination, physicians may hear a systolic murmur typically a crescendo - decrescendo murmur that increases in intensity during Valsalva manoeuvres. There is a S4 gallop. It is best heard with the bell of the stethoscope at the apex of the heart. Additionally, electrocardiography findings often show left ventricular hypertrophy, deep q waves and left atrial enlargement.
All patients with HCM should undergo these risk stratifications for sudden cardiac death and be evaluated for placement of an implantable cardioverter-defibrillator. Patient should avoid strenuous exercise as again this exacerbates the ventricular outflow tract obstruction.
Beta blockers are the initial therapy in patients with symptomatic HCM."
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[@armandohasudungan]

🎥 DON'T JUST WATCH, LEARN ACTIVELY! TRY THE QUIZ! 🤓 youmakr.ai/test-playground/questionnaire/673d33b7859b9c170836ead0

[@domingo4420]

Friendly reminder; if it is available in your country/region, opt to become an organ donor. I have HCM, and it's in the later stages. I've been on the heart transplant list for over a year now, and I'm just hoping I'll be able to make it to graduation next year. I know it is a morbid thought, but you can genuinely save multiple lives if you become a donor. Thank you for this informative video!

[@JorgeCarrasco-q5z]

u still doing alr?

[@mitshellm8521]

❤

[@05santorini]

My sister just passed away with this now we all have to get tested x

[@ziedjezawi2870]

My condolences bro 🥲

[@lilivaldez5663]

My fiancé passed away from this

[@khansultaan1990]

condolence buddy

[@BigRobMC]

Wow, my condolences to you and your family

[@Morilin]

I'm glad I found this, since I'm that 1 in 500. Even with a this diagnosis for over a decade you still taught me something new, so thank you for putting time into this video.

[@andrewjmy4919]

hi, is it true that this disease can be from unknown origin or be just genetic?

[@domingo4420]

@@andrewjmy4919 it is heavily influenced by genetics. if one of your parents have it, they have a 50% of passing it on to their children.

[@moberslife5941]

I’m, 23 I got diagnosed with this form of cardiomyopathy in April this year. However, my doctor called it Left Ventricular Non-Compaction Cardiomyopathy, I think it’s the same as Hypertrophic Cardiomyopathy, but I could be wrong. My Lvef is 55-60%, however my Rvef was 40% but I heard that is within a normal range too. I also took a BNP test(s) and both came back normal. So I don’t think I have heart failure at the moment, but I find myself feeling short of breath even though my blood oxygen saturation is always 97-100%. In addition I have mild mitral valve regurgitation. Honestly hearing all this stuff is still shocking especially at my age idk whether I need surgery or not. I’m on a low dose beta blocker called metoprolol, which has improved my blood pressure significantly, but idk I’m still processing how I got here and it’s scary at times but hopefully with a right diet and a lifestyle change I’ll be able to manage this. I’m praying for all of you having to go through this, but rest assured we will find a way 🙏🏾.

[@MM-wi5dn]

A good diet is always a good thing. But HCM will never go away unless you have a heart transplant. Surgery is a long way off, but you are so young it may be in the cards for you. One of the key stats you need to know is the thickness of the septum. Is it greater than 30mm? That would be very thick. The beta blocker only lowers your blood pressure it does not change the heart condition. Why did you see the cardiologist? What symptoms where you experiencing? If you are exercising vigorously and experiencing chest pain, shortness of breath, or diziness, be very careful. You may want to stop exercising vigorously. HCM can cause Sudden Cardiac Death in young athletes. What lifestyle change are you making? I also have HCM and am taking metoprolol, I am not young, I have done a lot of research, this is not going away.

[@kaushalyawagh9338]

​@@MM-wi5dnwhat is ur age and what r symptoms u have, Does metprolol help for ur symptoms

[@thefilmculturehindi]

I m on telma40 for lvh from a year ...I heard complete reversal is possible with ARB DRUGS 3 to 4 years...bp now normal....I had htn before

[@lazarus8453]

starts at 4:19

[@Marc2k6]

Wow!! Mind blown, just did a stress test BP was through the roof!! I have been having the signs that you mentioned for a long time!!🤷🏿‍♂️🤷🏿‍♂️🤷🏿‍♂️

[@frankelias1952]

Was just diagnosed with the obstructive today.

[@TheFolkhead]

I had to retire in my 50's because of Hypertrophic cardiomyopathy. I changed my diet. First KETO then Carnivore. I have more energy and better mental attitude. I don't think you can cure HCM but I feel like I have a lot of quality life ahead of me know.

[@dailydoseofmedicinee]

I hope, i can get this professionality, in my videos.

[@nehasaini4100]

You make everything simple and easy.. thank you 😍

[@captainjs6324]

4:08 Video starts

[@SpiritualGuruji]

vary good explanation thank you sir 🙏

[@qadijamohamud2887]

Thank you so much for this excellent explanation 🤩

[@kikokik4695]

🥰🥰🥰🥰 i love this channel so I'm one of the notification squad thank you guys❤

[@TheDutchGuyOnYT]

Tomorrow (if no emergency patient will come in between), I have my morrow procedure/ septal thinning. Mid 40’s, no identified gene. Hope I can get 70.

[@ShaDow-hl7vi]

I prefer this methode than writing thanks

[@ruthsimango6814]

Hi! Thank you for the amazing lecture. But what about minimal exercises as part of the treatment?

[@Morilin]

I'm no doctor but personally, I'd say any type of exercise really depends on the individual and their own personal disease progression. For example; with my condition I had to have open heart surgery roughly three years after my diagnosis. Now, 7 years later, I'm only to carry at most a gallon of liquid. I was 20 when diagnosed. Hopefully that answers your question?

[@mandarrajguru6946]

@@Morilin sorry to hear about you brother ..how much was your thickness ?

[@wendi2819]

@@Morilin I hope you are doing very well!

[@muppallpandu3297]

​@@Morilinhello sir, where your surgery was done and may I know the doctor please.how it is after surgery.

[@jaquelinvallejos2900]

everything is easy with your videos :D thank you

[@dmytro_rk]

Nice lecture, but it's really hard to understand without good subtitles

[@edwin-ny4ds]

Why not talk about the size of the ventricular wall mm?

[@wafaakamouna4172]

I need the pdf I'm from libya and i don't have visa for buy is there any other way ?

[@GPAT2021]

Ya that was so helpful but keep in mind one thing good handwriting touches the mind more easily :🤗

[@smilyyyflower175]

but here its written as well,.?

[@2bidy]

@@smilyyyflower175 a little strain increases understanding i think his handwriting is clear.

[@tunebug10]

The most common is actually Dilated! In nursing school right now and just wanted to let everyone know for studying purposes! (: Great video other than that though!

[@dudemansam93]

The most common cardiomyopathy in general is dilated, you're right! However, he says that hypertrophic cardiomyopathy is the most common PRIMARY type of cardiomyopathy (i.e. not the result of other pathology) which is correct! Hope that makes sense :)

[@randomizerL2012]

Auto click whenever I see your lectures 😊 how I wish I have those drawing skills tho 😄 Thanks alot!

[@DCassidy42]

Currently waiting on an mri to determine a diagnosis. 32 years old, I've previously had higher blood pressure prior to loosing 50lbs, also have been doing a ton of cardio vascular exercises in the past 2 years and no known family history of hcm. I'm hoping my mild hypertrophy is due to exercise and not a genetic disease.

[@arshanapallivarunrao9603]

Do you have hcm?

[@DCassidy42]

@@arshanapallivarunrao9603 so far it sounds like it, a mri next month will provide more clarity to make a finalized diagnosis.

[@pgio2000]

@@DCassidy42 How are you doing now ?

[@Morilin]

Hopefully you got a good diagnosis? But, also, one can be the first in their family to be diagnosed. I am.

[@adsoyad825]

@@Morilin get well soon. I am writing from Turkey. Our disease starts at the same age. I am 27 years old, I have a battery in my heart. Let's pray to God. This is the world of testing.

[@kainatkhan1336]

Just love these videos 💕💕💕

[@584emad]

You did not mention anything about T wave inversion.

[@hebaefat61]

Thanks for the lecture Can cardiomyopathy occur with normal Echo and bradycardia, around 50

[@shubhamsharma-fg5mv]

Wow explanation 👍👍❣️❣️

[@adwoaasare3621]

Miss seeing your hand

[@etharibrahim7576]

thank you very much

[@marc5206]

Awesome. Thank you.

[@debralong1740]

What causes chest pain in HOCM patients? Is it concerning?

[@Morilin]

It depends. The condition effects the electrical impulse that controls the rhythm of the heartbeat, when that is affected, the heartbeat can speedup, or slow down, both painful, and theres a chance the heart will just stop. Personally, my doctors had a pacemaker in me two weeks after diagnosis. And of course the thickening of the muscle also affects the bloodflow, and thickened muscle isnt as flexible as it should be, also causing issues - and pain as well. Using me as an example again, I ended up needing a surgery where they went in and shaved off some of the excess muscle on and in my heart. Yup, open heart surgery. It's just a big bag of ouch all around.

[@MM-wi5dn]

My cardiologist said it is from the blood flow and valve operation causing the pain as the valve does not have the space it should to open and close due to the thickened septum. When you exercise the heart beats faster and the valve moves faster and thus the pain increases, as does the shortness of breath, and diziness due to lack of oxygen to the body and brain. The EKG and ECHO will determine if you have a-fib which I do not and therefore do not need a pacemaker. The ECHO wil determine the thickness of the septum which determines if and how soon you might need surgery, in conjunction with symptoms, quality of life, age, etc. The first order of treatment is medications. Surgery is always risky and should be done by a Dr who has done hundreds of the HCM septum shaving procedures such as at Cleveland Clinic.

[@divyanshvishwkarma9548]

Does HCM patient have to have Holter monitor for 24/7, or just dor testing

[@lukeclaudio7936]

As a HCM patient since birth I know a lot about this disease. To answer your question yes we do have to where a Holter Monitor.

[@dr.khaoula7836]

You can detect some pathology from estimation of cardiac pressure ....i mean PCG signal ???!!!

[@MKMediGuideLectures]

Amazing 😊

[@ziedjezawi2870]

I was power lifter for 15 years, i checked my heart eco , i have very little thickness of interventricular septum with no symptoms, is it ok????

[@Morilin]

If you've got no symptoms I'd say just make sure to keep watch on that thickening. It might get worse, in most people the thickening of the muscle isn't even, causing blockage.

[@ziedjezawi2870]

@@Morilin my cardiologist said its normal and that because of years of hardcore training, anyway he said i should check annually

[@leo725fwk]

why valsalva (decreasing preload) will lead to louder murmur while handgrip (increasing afterload) lead to lighter murmur? what are the mechanisms behind?

[@DA-zc9tk]

May be because during valsalva preload inc hence the valves are separated wide apart during inc in after load it has to contract n the valves are coming closer resulting in louder murmur , not sure but I think this is the explanation

[@Peace-81]

During valsalva intrathoracic pressure increases which decreases venous return thereby preload which leads to small lv cavity which enhances lv outflow tract obstruction hence the resistance to emptying of blood from lv to aorta thereby high velocity blood flows across aortic valve producing murmur with increased intensity. During sustained hangrip peripheral arterioles get squeezed causing resistance to forward flow of blood thereby increases lv afterload and reduces ventricular emptying time...this produces relative increase in lv volume during systole thereby decreasing intensity of murmur

[@TheWindsweptwanderer]

Isn't most common cardiomyopathy dilated cardiomyopathy and not hypertrophic cardiomyopathy

[@sofiurrahaman2026]

I want to hear in hindi

[@shoebee5235]

04:11

[@ghadeerer9052]

🤍🤍🤍👌🏻

[@al-hassanhaider9327]

Thank you so much