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Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

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Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Layers of the Heart Wall01:15

Layers of the Heart Wall

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The heart wall comprises three distinct layers: the epicardium, myocardium, and endocardium. The outermost layer, the epicardium, is the visceral layer of the serous pericardium, featuring a thin, transparent mesothelial surface and an inner layer of areolar connective tissue with fat deposits that increase with age.
The myocardium, the thickest layer, consists of cardiac muscle cells interconnected by intercalated discs and crisscrossing connective tissue fibers. These muscle fibers contract...
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Hypertrophic cardiomyopathy - phenotypic variations beyond wall thickness.

Nikhil Goyal1, Graham Keir1, Yonah B Esterson1

  • 1Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA.

Clinical Imaging
|January 21, 2023
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Summary

Hypertrophic cardiomyopathy (HCM) involves left ventricular hypertrophy (LVH) without other causes. Recognizing associated anatomic variations aids early diagnosis and treatment, even without significant LVH.

Keywords:
Displaced papillary musclesHypertrophic cardiomyopathyLeft ventricular myocardial bandsMitral valve leaflet elongationMyocardial crypts

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Pathology

Background:

  • Hypertrophic cardiomyopathy (HCM) is defined by left ventricular hypertrophy (LVH) unexplained by other cardiac or systemic diseases.
  • Understanding the diverse morphologic and histologic changes in HCM is crucial for accurate interpretation of cardiac imaging.
  • Early detection of HCM-associated findings can lead to timely diagnosis and management, improving patient outcomes.

Purpose of the Study:

  • To describe the spectrum of morphologic variations in hypertrophic cardiomyopathy (HCM) beyond myocardial thickening.
  • To highlight key imaging features of associated cardiac structures in HCM.
  • To emphasize the importance of recognizing these variations for early diagnosis and treatment.

Main Methods:

  • Review of imaging findings in patients with hypertrophic cardiomyopathy (HCM).
  • Description of characteristic morphologic variations including papillary muscle and mitral valve abnormalities, myocardial crypts, and left ventricular bands.
  • Discussion of dystrophic calcification patterns associated with increased myocardial tension.

Main Results:

  • Morphologic variations in HCM extend beyond simple myocardial thickening.
  • Key findings include abnormalities of papillary muscles and mitral valve, myocardial crypts, and ventricular bands.
  • Dystrophic calcification may be present, reflecting increased myocardial wall tension.

Conclusions:

  • Recognizing diverse morphologic variations in HCM is essential for accurate diagnosis and management.
  • Associated findings may be present even in the absence of significant left ventricular hypertrophy (LVH).
  • Comprehensive imaging interpretation aids in the early identification and treatment of hypertrophic cardiomyopathy (HCM).