Hypertrophic Cardiomyopathy Patients Undergoing Noncardiac Surgery: The Proverbial Pandora ’s Box

HYPERTROPHIC CARDIOMYOPATHY (HCM) has been described since the 1800s, but it was not until the mid-1960s that the first cases were reported in the literature.1 Characterized by hypertrophy, HCM is a heterogenous disease of all age groups2 that develops in absence of a physiological cause. The disease carries a wide array of manifestations and hemodynamic alterations.3 Even though some patients present with the usual symptoms (fatigue, dyspnea, chest pain, palpitations, or syncope), other patients are asymptomatic with an incidental diagnosis made on echocardiographic findings.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research

Related Links:

In conclusion, both painless ischemia and painful ischemia are associated with a gradual, significant increase in NT-proBNP/ULN in comparison to the double-negative hsTnI/AP subgroup. In contrast, NT-proBNP is significantly higher in only the subgroup with painful ischemia. PMID: 31320942 [PubMed - in process]
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
Authors: Parlar-Chun R, Kakarala K, Singh M Abstract Patients hospitalized for asthma can exhibit concurrent cardiac symptoms and undergo cardiac work up. We identify patients admitted for asthma that underwent cardiac workup and describe outcomes to evaluate the utility of cardiac testing in this population. Patients aged 4 to 17 years admitted for status asthmaticus from 2012 - 2016 were screened for EKG, ECHO, or cardiac enzyme obtainment. Out of 1296 patients, 77 (6%) received cardiac testing. The most common reasons for testing were chest pain (25, 32%), blood pressure abnormalities (11, 14%), tachycardia (8, ...
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
Rationale: Apical hypertrophic cardiomyopathy (AHCM) is a rare form of hypertrophic cardiomyopathy which affects predominantly the apex of the left ventricle. Generally, left ventricular enlargement is not present in AHCM; additionally, endomyocardial fibrosis, and calcification are also rare. Patient concerns: A 61-year-old female (Case 1) and a 60-year-old female (Case 2) both presented with the symptoms of atypical chest pain, dyspnoea, exercise intolerance, palpitations. Diagnosis: Magnetic resonance and single-photon emission computed tomography (SPECT) revealed apical hypertrophic cardiomyopathy. Furthermore,...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
What do you think of these ECGs?I came across the first one reading it blind for a study.  I was certain I knew the diagnosis, and went to the chart to confirm.The first 3 were recorded on one day.ECG 1:ECG 2:ECG 3:ECG 4, recorded 12 days later:These ECGs are classic for abenign variant in Black males.  I was certain it would be a relatively young black male without cardiac pathology.Result from chart:It was a black male in his 40s.The first ECG, and then the next two (1-3), were recorded for chest and abdominal pain.  The patient was ultimately diagnosed with biliary colic.The patient ruled out for MI by se...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion The m.10191T>C mutation in the mtDNA of the complex I (CI) subunit of MTND3 results in the substitution of a highly conserved amino acid (p.Ser45Pro) within the ND3 protein, leading to CI dysfunction through impaired enzyme catalysis rather than impaired stability or assembly, causing a broad clinical spectrum of disorders (26). Patients with the m.10191T>C mutation are rare. In the present study, we report on a family of patients with the extremely rare adult-onset Leigh-like syndrome with the m.10191T>C mutation. Including the two patients from our reported family, the m.10191T>C mutation has bee...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionsIn this cohort, participation in thrill-seeking activities rarely caused major adverse events. This information can be used for shared-decision making between providers and patients.Abstract word count: 249Keywords: hypertrophic cardiomyopathy, thrill-seeking activities, rollercoaster.
Source: American Heart Journal - Category: Cardiology Source Type: research
AbstractPurpose of ReviewIn hypertrophic cardiomyopathy (HCM), the presence of vessel abnormalities with microvascular dysfunction is a well-known feature. The aim of this review is to present the evidences that support this notion and to describe the physiopathologic and clinical consequences of microvascular dysfunction.Recent FindingsAfter having demonstrated the presence and significance of microvascular dysfunction in HCM, the myocardial blood flow (MBF) measurement by positron emission tomography (PET) is ready to develop into a clinical tool for disease evaluation, in particular for patient prognostication. Alternat...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research
ConclusionsThe cardiovascular death and cardiovascular events are significantly increased in patients with HOCM and CAD who underwent CABG at the time of septal myectomy.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease, causing breathlessness, chest pain, syncope and sudden death. One-year outcome of echo-guided transthoracic percutaneous laser ablation (TPLA) of the sheep interventricular septum was studied as a novel treatment to reduce the septal thickness. It may partially address the limitations of surgical myectomy and alcohol septal ablation in terms of trauma, safety, and efficacy.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Written by Pendell Meyers with edits by Steve SmithI was sent these 2 ECGs with no clinical information other than chest pain:Do either or both of these ECGs show ischemic changes? If so, what should you do and why?Let's take them one at a time.What would your response be?I responded: " Awesome classic benign T wave inversion! That's the patient's baseline normal variant. ... But if it were a good story with exertional syncope or something you'd have to treat it like it could be HOCM, etc. Tell me more. "There is sinus rhythm with very large voltage and associated repolarization abnormalities. In V3-V6 there are ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
More News: Anesthesia | Anesthesiology | Cardiology | Cardiomyopathy | Heart | Hypertrophic Cardiomyopathy | Pain