Page 207 - 2021 IDMT Digital

HYPERTROPHIC CARDIOMYOPATHY (HCM)
Introduction:
• +\SHUWURSKLF &DUGLRP\RSDWK\ +&0 LV WKH OHDGLQJ FDXVH RI VXGGHQ GHDWK DPRQJ
\RXQJ DWKOHWHV
• +&0 RFFXUV ZKHQ WKH VHSWXP LV HQODUJHG DORQJ ZLWK HQODUJHPHQW RI WKH /9 WLVVXH
o 7KLV FDQ OHDG WR heart DUUK\WKPLDV FDXVLQJ sudden GHDWK
Subjective:
• 6LJQV DQG 6\PSWRPV
o )LUVW VLJQ RI +&0 PLJKW EH GHDWK
o 6KRUWQHVV RI EUHDWK HVSHFLDOO\ GXULQJ H[HUWLRQ
o &KHVW SDLQ
ƒ 6\QFRSDO HSLVRGH SRVW-H[HUWLRQ
• )RFXVHG +LVWRU\
o 6\QFRSDO HSLVRGHV
o )DPLO\ KLVWRU\ RI VXGGHQ FDUGLDF GHDWK 6&'
o 6KRUWQHVV RI EUHDWK RU FKHVW SDLQ HVSHFLDOO\ ZLWK H[HUFLVH
Objective:
• 3K\VLFDO ([DP
o %LVferious SXOVH GRXEOH SXOVH IHOW ZLWK V\VWROLF EHDW DW FDURWLG DUWHU\
o /RXG V\VWROLF PXUPXU WKDW GLVDSSHDUV ZKLOH VTXDWWLQJ DQG JHWV ORXGHU ZKHQ
VWDQGLQJ RXWIORZ REVWUXFWLRQ
• 7RROV
o (.* may VKRZ OHIW YHQWULFXODU K\SHUWURSK\ /9+ or non-specific abnormalities
Assessment:
• 'LIIHUHQWLDO
o 0, (.* ZLOO LQGLFDWH 67 HOHYDWLRQ
o 9HQWULFXODU 7DFK\FDUGLD
o 9HQWULFXODU )LEULOODWLRQ
o 6\QFRSH SDWLHQW PD\ KDYH KLVWRU\ RI QXPHURXV HSLVRGHV
o +HDUW IDLOXUH DGYHQWLWLRXV VRXQGV SHULSKHUDO HGHPD ZLOO EH SUHVHQW
Plan:
• 3UHSDUH IRU $&/6 LQWHUYHQWLRQ
• ,I VXVSLFLRXV 3( (.* ILQGLQJV FRQWDFW pUHFHSWRU
o &RQVLGHU LPPHGLDWH HYDFXDWLRQ IRU FDUGLRORJ\ HYDOXDWLRQ
• $YRLG H[HUWLRQDO DFWLYLWLHV XQWLO FOHDUHG E\ FDUGLRORJ\
• &RQVLGHU VFUHHQLQJ WDFWLFDO DWKOHWHV

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