Description hypertrophic cardiomyopathy
In the beginning it is necessary to clarify and define the term cardiomyopathy. Cardiomyopathy is defined as a primary disease of the heart muscle (hereinafter referred to as the myocardium), which are guided primarily impaired cardiac function. Impaired cardiac function lies primarily in the reduced ability to contraction or dilatation of the myocardium.
Cardiomyopathy is divided according to the prevailing changes inhypertrophic, dilated and restrictive. All three types of cardiomyopathies have common certain features, it is primarily an increase of pressure in the ventricles during a cardiac diastolic end.
Cardiac diastole is the period of the cardiac cycle (heart Revolution) at which it is released and stretched heart muscle. In diastole is also open communication between the atria and ventricles (ie. CIPA flaps are open). From the atria to ventricles are the blood flows. But in the chambers is increased in pressure due to cardiomyopathy than usual. This increased pressure is propagated back to the hall and through them to the venous system. Disability left ventricle is regular, therefore, the left atrium is enlarged.
Risk factors of hypertrophic cardiomyopathy
Disease is an inherited, arises due to the mutation of genes.
Prevention of hypertrophic cardiomyopathy
The reason that this is a congenital disease, no prevention exists.
Signs and symptoms of hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a genetic disease. Furthermore, it must be said that this is anautosomal dominant disease with frequent family history. Currently, the 11 known genes whose mutation and thus withdrawal of the correct operation leads to the disease. These are genes whose activity is closely related to cardiac activity. The result is a disorder of the sarcomere muscle fibers of the heart (Sarcomere is the basic functional unit of muscle fiber. This Sarcomere is always dysfunctional, and therefore can be considered hypertrophic cardiomyopathy as a kind of compensatory responses, because enlargement of muscle fibers (hypertrophy), this status may actually partially compensate.
Hypertrophic cardiomyopathy is characterized mainly by hypertrophy. Reason hypertrophy was explained above. Hypertrophy (increase in muscle fiber size and volume) is affected mainly left ventricle and septum.
Systolic function of the heart (systole is the time when there is muscle contraction and expulsion of blood from the left ventricle into the aorta) may be normal or reinforced. This is not the problem.Contrary problem arises when the second phase of the cardiac revolution, and during diastole. The mighty muscle of the left ventricle is worse relaxovatelná, so there is not create so much space for flowing blood from the left atrium.
Consequently, there is a rapid rise of pressure in the left ventricle during cardiac diastole, that is propagated backwards, ie in the left atrium and venous system. Flowing into the left atrium four pulmonary veins that bring from the lungs to the heart with oxygenated blood which is across the left ventricle and the aorta is distributed further into the body. As a result of increased pressure in the atrium and venous system it happens that the blood stagnates in the lungs and leads to the state of congestion of the lung (lung congestion).
When thickening of the ventricular septum (septum between the right and left ventricle) can occur when the contraction of the left ventricle (systole) for a partial closure of the outflow of the left ventricle, thereby reducing the stroke volume (simply put, reduced the amount of blood flowing into the aorta and into the body). However, there is also a violation anatomical proportions, and thus may cause a malfunction of the mitral valve closure, it becomes insufficiency (nedovíravá), which further reduces the stroke volume because of the blood is returned through a faulty valve during contraction into the hall.
Hypertrophic cardiomyopathy may occur long latent (without symptoms), on the other hand, can cause sudden death. Sudden death affects young people, and often top athletes. The reason is that this way the affected chamber is greater susceptibility to ventricular fibrillation (a type of arrhythmia that is reflected chaotic and very rapid contraction of the heart, when not enough into the chambers receive blood and cardiac output drops to zero, which leads to heart failure and death)
If hypertrophic cardiomyopathy causes symptoms, so they are: dyspnea, syncope, and angina pectoris.
Dyspnea or breathlessness is a subjective feeling of respiratory insufficiency. This is due to congestion (congestion of the lungs, see above), which is the reason for decreased lung compliance (lung compliance). Therefore, to ensure sufficient ventilation of the lungs, they must increase their efforts by generating more pressure, which results in a feeling of respiratory insufficiency.
Angina pectoris is the scientific name for anginal chest pain (known as angina). Blunt gripping pain arises due to inadequate myocardial perfusion. Myocardium is much greater, therefore, needs a greater amount of oxygen addition, the diffusion path for oxygen is increased. At higher pressure in the chambers is also greater oxygen uptake. These are the three main reasons for the emergence of pain known as angina.
Syncope is defined as a sudden loss of consciousness, and may be caused at the beginning of a physical effort due to hypertrophy of the ventricular septum, which partially blocks the outflow of the left ventricle (see above). The cause unconsciousness may also be cardiac fibrillation (see above).
The treatment of hypertrophic cardiomyopathy
It is used PTSM (percutaneous transluminal septal ablation), which removes part of the septum, which may enter into the outlet part of the left ventricle.
Alcohol septal ablation is performed such that in a specific portion of the left coronary artery is injected ethanol.
Pharmacological treatments include beta-blockers (metoprolol, atenolol). Furthermore, calcium channel blockers and diuretics.
In the case of arrhythmia introducing a pacemaker.
How can I help myself
Avoid sports and stressful situations.
Complications hypertrophic cardiomyopathy
The most serious complication is the sudden death of the organism due to the occurrence of ventricular fibrillation.
Other names: cardiomyopathy with obstruction, cardiomyopathy without obstruction, asymmetric septal hypertrophy, muscular subaortic stenosis, idiopathic hypertrophic subaortic stenosis
