Cardiomyopathy , HOCM In MRCP Part 1
Category : Cardiomyopathy , MRCP Part 1
Introduction
Myocardium is the main functional part of the heart. Heart failure is synonymous with failure of cardiac muscle. Myocardium may be affected by disease of muscle itself ( Primary) or due to effect of other disease process ( Secondary) or by coronary artery disease. Interestingly, as cardiac muscle is anatomically related with skeletal muscle ( striated muscle) , primary disease of skeletal muscle involves cardiac muscle also.
Clinical types of Cardiomyopathy
Mainly as below:
- Dilated cardiomyopathy ( Systolic heart failure)
- Hypertrophic cardiomyopathy of multiple varieties ( Diastolic heart failure)
- Restrictive cardiomyopathy ( Diastolic heart failure)
Of them, HOCM ( Hypertrophic Obstructive Cardiomyopathy) is the most common.
Clinical Presentation
Patient presents with symptoms of dyspnoea, angina and syncope due to outflow obstruction. Moreover there would be other-
- Clinical features of Heart failure
- Clinical features of Arrhythmia
- Clinical features of primary disease / cause
Bad prognostic feature ( risk factors of sudden cardiac death) of HOCM
Exercise induced hypotension is the most important
Investigation ( ECG, Echo, Electrophysiological Study, BNP, Electrolyte etc)
- To diagnose heart failure ( eg Echo or cardiac MRI)
- To identify causes of heart failure eg IHD
- To identify complications eg renal function
- To identify prognostic factor or co morbidities
Management
- Management of heart failure
- Management of Arrhythmia ( eg ICD)
- Management of primary disease / cause