Abstract
HCM(=Hypertrophic Cardiomyopathy) is a primary cardiac disease and its characteristic morphologic abnormality is a hypertrophied and nondilated left ventriclar in the absence of another cardiac or systemic disease that itself is capable of producing left ventricle hypertrophy. The symptoms of HCM are varied and include dyspnea, orthopnea, fatigue, chest pain, palpitations and impaired consciousness. The pathophysiologic components of the disease process are left ventricular outflow obstruction, diastolic dysfunction, myocardial ischemia, and arrhythmia. Predicting the clinical course and outcome for individual patients with HCM has been difficult because of variability in natural history and the complexity in disease expression.
The present report describe a patient with am asymptomatic, pathologic Q wave in whom HCM was diagnosed by echocardiography, MIBI-SPECT, coronary angiography, and left ventriculography.
References
1). Braunwald E. Hypertrophic cardiomyopathy continued progress. N Engl J Med. 320:800. 1989.
2). Hypertrophic cardiomyopathy. fowler, NO: Diagnosis of heart disease. New York: Springer-Verlag;1991. p. 256–267.
3). Morrow AG, Braunwald E. Functional aortic stenosis: A malformation characterized by resistance to left ventricular outflow without anatomic obstruction. Circulation. 20:181. 1959.
4). Maron BJ, Bonow RO, Cannon RO, et al. Hypertrophic cardiomyopathy: Interrelations of clinical manifestations pathophysiology, and therapy. N Engl J Med. 316:780. and 844. 1987.
5). Jarcho JA, McKenna W, Pare JAP, et al. Mapping a gene for familial hypertrophic cardiomyopathy to chromosome 14ql N Engl J Med. 321:1372. 1989.
6). Maron BJ, Mulvihill JJ. The genetics of hypertrophic cardiomyopathy. Ann Intern Med. 105:610. 1986.
7). Maron BJ, Spirito P, Green KJ, Wesley Y, Bonow RO, Arce J. Noninvasive assessment of Left Ventricular Diastolic Function by Pulsed Doppler Echocardiography in Patients With Hypertrophic Cardiomyopathy. J Am Coll Cardiol. 10:733–742. 1987.
8). Takenaka K, Debestani A, Gardin JM, Russell D, Clark S, Allfie A, Henry WL. Left Ventricular Filling in Hypertrophic Cardiomyopathy: A Pulsed Doppler Echocardiographic Study. J Am Coll Cardiol. 7:1263–1271. 1986.
9). Lund DD, Tomanek RJ. Myocardial morphology in spontaneously hypertensive and aortic-constricted rats. Am J Anal. 152:141–151. 1978.
10). Cannon III RO, Rosing DR, Maron BJ, Leon MB, Bonow RO, Watson MR, Epstein S. Myocardial ischemia in patients with hypertrophic cardio-myopathy: Contribution of inadequate vasodilator reserve and elevated left ventricular filling pressures. Circulation. 71:234–243. 1985.
11). Spirito P, Maron BJ. Relation Between Extent of Left Ventricular Hypertrophy and Occurrence of Sudden Cardiac Death in Hypertrophic cardiomyopathy. J Am Coll Cardiol. 15:1521–1526. 1990.
12). Codd MB, Sugrue DD, Gersh BJ and Melton LJ III. Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy. Circulation. 80:564. 1989.
13). Stevenson LW, Tillisch JH. Maintenance of cardiac output with normal filling pressures in patients with dilated heart failure. Circulation. 74:1303. 1986.
14). Pearce PC, Hawkey C, Symons C, Olsen EG. Role of calcium in the induction of cardiac hypertrophy and myofibrillar disarray. Experimental studies of a possible cause of hypertrophic cardio-myopathy. Br Heart J. 54:420. 1985.
15). Gwathmey JK, Copelas L, MacKinnon R, et al. Calcium-antagonist receptors in the atrial tissue of patients with hypertrophic cardiomyopathy. N Engl J Med. 320:755. 1989.
16). Koga Y, Itaya M, Toshima H. Increased cardiovascular response to epinephrine in hyper-trophic cardiomyopath. Jpn Heart J. 26:727. 1985.
17). Olsen EG. An endocrine experimental model for myofibrillar disarray as found in hypertrophic cardiomyopathy. J Mol Cell Cardiol. 17:35. 1985.
18). Lawson JWR. Hypertrophic cardiomyopathy: Current views on etiology, pathophysiology, and management. Am J Med Sci. 294:191. 1987.
19). Brush JE Jr, Eisenhofer G, Garty M, et al. Cardiac norepinephrine kinetics in hypertrophic cardiomyopathy. Circulation. 79:836. 1989.
20). Hirzel HO, Tuchschmid CR, Schneider J, et al. Relationshp between myosin isoenzyme composition, hemodynamics, and myocardial structure in various forms of human cardiac hypertrophy. Circ Res. 57:729. 1985.
21). Spirito P, Chiarella F, Carratino L, et al. Clinical course and prognosis of hypertrophic cardiomyopathy in an outpatient population. N Engl J Med. 320:749. 1989.
22). Maron BJ, Gottdiener JS, Epstein SE. Patterns and Significance of Distribution of Left Ventricular Hypertrophy in Hypertrophic Cardiomyopathy: A Wide Angle, Two Dimensional Echocardiographic Study of 125 Patients. Am J Caridiol. 48:418. 1981.
23). 임상욱 · 정 냥식 ‘ 하종원 · 권 준 ’ 차동훈 · 이 운 형· 권혁운· 심원홉·초승연’검성순 ·김한수; 한국인의 비후성 성근증의 심초응파도에 의한 형 태 학척 분류. 순한기. 25(3):568. 1995; 25: 3: 568, 1995.
24). O'Gara PT, Bonow RO, Maron BJ, et al. Myocardial perfusion abnormalities in patients with hypertrophic cardiomyopathy: Assessment with thallium-201 emission computed tomography. Circulation. 76:1214. 1987.
25). Bonow RO, Maron BJ, Leon MB, et al. Medical and surgical therapy of hypertrophic cardiomyopathy. Cardiovasc. Clin. 19:221. 1988.
26). Sugrue DD, Dickie S, Myers MJ, et al. Effects of amiodarone on left ventricular ejection and filling in hypertrophic cardiomyopathy as assessed by radionuclide angiography. Am J Cardiol. 54:1054. 1984.
27). McKenna WJ, Oakley CM, Krikler DM, Goodwin JF. Improved survival with amiodarone in patients with hypertrophic cardiomyopathy and ventricular tachycardia. Br Heart J. 53:412. 1985.
28). Counihan PJ, McKenna WJ. Low-dose amiodarone for the treatment of arrhythmias in hypertrophic cardiomyopathy. J Clin Pharmacol. 29:436. 1989.
29). McIntosh CL, Maron BJ. Current operative treatment of obstructive hypertrophic cardiomyopathy. Circulation. 78:487. 1988.