Hypertrophic cardiomyopathy

被引:4
作者
John T. Barron
机构
[1] Rush-Presbyterian-St. Luke’s Medical Center,Department of Internal Medicine, Section of Cardiology
关键词
Sudden Cardiac Death; Outflow Tract; Hypertrophic Cardiomyopathy; Main Side Effect; Disopyramide;
D O I
10.1007/s11936-999-0044-2
中图分类号
学科分类号
摘要
The degree of clinical expression of both obstructive and nonobstructive hypertrophic cardiomyopathy (HCM) is widely variable. Many patients with HCM are asymptomatic or minimally symptomatic. Most patients with mild or moderate HCM respond well to medical therapy, but medical therapy in patients with severe disease is only marginally beneficial. In some instances, medical therapy can even complicate management by producing significant conduction disturbances. Most symptomatic patients with a significant resting outflow tract gradient may respond to atrioventricular sequential electronic pacing. Most of these patients eventually become symptomatic again, however, because of progression of the disease process or other unknown factors. The outcome of myotomy-myectomy depends greatly on the surgeon’s experience with this surgical procedure. In patients with very severe hypertrophy or evidence of left ventricular dilatation and systolic dysfunction, cardiac transplantation should be considered earlier than it would be on the basis of symptoms, functional capacity, and other factors.
引用
收藏
页码:277 / 282
页数:5
相关论文
共 45 条
[1]  
Braunwald E(1989)Hypertrophic cardiomyopathy—continued progress N Engl J Med 320 800-804
[2]  
Goodwin JF(1976)Arrhythmia as a cause of sudden cardiac death in hypertrophic cardiomyopathy Lancet 2 937-940
[3]  
Krikler DM(1971)Cardioselective beta-adrenergic blockade in hypertrophic cardiomyopathy Postgrad Med J 47 93-101
[4]  
Webb-Peploe MM(1994)Hypertrophic cardiomyopathy Prog Cardiovasc Dis 36 275-308
[5]  
Croxson RS(1994)Long-term results of dual chamber (DDD) pacing in obstructive hypertrophic cardiomyopathy: evidence for progressive symptomatic and hemodynamic improvement and reduction in left ventricular hypertrophy Circulation 90 2731-2742
[6]  
Oakley CM(1997)Dual-chamber pacing for patients with hypertrophic obstructive cardiomyopathy: a prospective randomized, doubleblind cross-over study J Am Coll Cardiol 29 435-441
[7]  
Louie EK(1996)Long-term results of left ventricular myotomy and myectomy for obstructive cardiomyopathy J Thorac Cardiovasc Surg 111 586-594
[8]  
Edwards LC(1996)Clinical demographic and pathologic profile of sudden death in 158 young competitive athletes JAMA 276 199-204
[9]  
Fananapazir L(1985)Improved survival with amiodarone in patients with hypertrophic cardiomyopathy and ventricular tachycardia Br Heart J 53 412-416
[10]  
Epstein ND(1989)Sudden death in hypertrophic cardiomyopathy: assessment of patients at high risk Circulation 80 1489-1492