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The idiopathic hyperkinetic heart syndrome: clinical course and long-term prognosis
Insights
Idiopathic hyperkinetic heart syndrome patients often show symptom resolution and improved physical findings over time. Uncomplicated cases demonstrate an excellent long-term prognosis with minimal residual effects.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Idiopathic hyperkinetic heart syndrome (IHHS) is a condition characterized by an overactive heart.
- Long-term outcomes for IHHS patients were not well-established.
Purpose of the Study:
- To assess the long-term prognosis of patients diagnosed with idiopathic hyperkinetic heart syndrome.
Main Methods:
- Follow-up of 19 patients diagnosed with IHHS for 11 to 25 years.
- Clinical re-examinations, ECGs, and cardiac catheterization in a subset of patients.
Main Results:
- One patient died from mitral stenosis; 18 were re-evaluated.
- Most patients showed regression of symptoms, murmurs, and ECG abnormalities.
- Only one patient remained symptomatic with congestive cardiomyopathy.
Conclusions:
- Uncomplicated idiopathic hyperkinetic heart syndrome generally has an excellent long-term prognosis.
- The condition often resolves or significantly improves over decades.
Abstract:
Nineteen of the originally reported 24 patients having the idiopathic hyperkinetic heart syndrome were followed for periods of 11 to 25 years. One patient died of complicating severe mitral stenosis. Of the remaining 18 patients, nine had complete physical examinations and ECG records. Only one of these patients was symptomatic at the time of reexamination. Murmurs originally present in eight of nine patients were present in only five of nine at reexamination; hyperkinetic circulation and heart, originally present in eight, were found in only two at follow-up; and systolic hypertension, present in seven at beginning of the study, was only present in four at follow-up. ECG abnormalities (usually left ventricular hypertrophy) regressed in the majority. Persistent elevation of cardial index and systolic ejection rate were found at repeat catheterization in the single symptomatic patient who had congestive cardiomyopathy. Uncomplicated idiopathic hyperkinetic heart syndrome appears to have an excellent long-term prognosis.