Changes Associated With Left Ventricular Hypertrophy With Changes With T Wave Inversion And Deep Q Waves

Apical hypertrophic cardiomyopathy is a disease that mainly affects the apex of the heart and does not cause any obstruction. [1] These abnormalities in the heart muscle can cause a wide variety of symptoms. As the heart becomes stiff it increases the pressure in the left ventricle which can push blood back into the lungs, causing shortness of breath in exercise. Chest pain can occur as there is not enough oxygen available to the cardiac muscle due to insufficient blood supply. Palpitations and lightheadedness, along with other conditions can occur as a result of HCM. In addition to these discomforting symptoms, the patient may develop an arrhythmias that often goes unnoticed. An arrhythmia takes place as the electrical conduction of the heart is disturbed by the abnormal scattering of myocytes. The two most common arrhythmias are atrial fibrillation causing palpitations, and ventricular tachycardia that can be life threatening causing sudden death. Both conditions can be controlled with medication. [4]

As this disease progresses and the workload of the heart is consistently increased, ventricular hypertrophy occurs. At first, the hypertrophied heart muscles will increase contractility, thus increasing cardiac output; however, as hypertrophy of the ventricular myocardial cells continues, it begins to have poor contractility, requires more oxygen to perform, and has poor circulation from the coronary arteries. This can result in heart tissue ischemia and lead into cardiac dysrhythmias (Lewis et al. 2014, 768).

Young children who have hypertrophic cardiomyopathy tend to have no symptoms of their condition until

Tachycardia: Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate. When the heart beats rapidly, the heart pumps less efficiently and provides less blood flow to the body and the heart. The rapid heartbeat increases the workload and oxygen demand of the heart. Problems will occur with the heart as tachycardia persists over time. The heart is maintaining less oxygen, which will lead to an MI due to death of the myocardial cells. Patient will start to have angina because of this. Tachycardia is noted in many diseases and disorder like: fever endocarditis, anemia, HTN, pericarditis, abnormal heart impulses, anxiety, older age, sleep apnea, COPD, electrolyte imbalances, and many more.

HCM happens when the heart muscle enlarges and thickens without an obvious cause. Usually the ventricles, the lower chambers of the heart, and septum thicken. The thickened areas create narrowing or blockages in the ventricles, making it harder for the heart to pump blood; however, in very few instances the heart actually contracts with much greater force causing an obstruction to the blood flow (CMUK, 2015). HCM also can cause stiffness of the ventricles, changes in the mitral valve, and cellular changes in the heart tissue.

As cardiomyopathy progresses, the heart becomes weaker and is less able to pump blood normally. This results in heart failure. There are different types of cardiomyopathy- hypertrophic, dilated, and restrictive. Hypertrophic cardiomyopathy occurs when the heart muscle cells enlarge which causes the thickening of the left ventricular wall. Although the ventricle size stays normal, the thickening makes it harder for the heart to pump blood. In some cases, the septum also thickens and expands to the left ventricle which causes a blockage of blood flow out of the left ventricle. The cause of the disease is unknown but hypertrophic cardiomyopathy is usually caused by changes in the genes in heart muscle proteins. It can also develop due to

Right-sided heart failure can be ruled in. When the heart is backed up it produces an overload of fluid in the lungs and entire body. As fluid accumulates in the lungs it can cause chest tightness, sob, jugular vein distention and coughing which produces a pink frothy colored sputum in which patient is positive for. Although this diagnosis has strong symptomology the BNP is normal and the diagnosis of Heart failure may be ruled out. (Dunphy & Winland-Brown,

Risk for having CAD or established CAD, previous MI or heart failure with decreased ejection fraction and ventricular arrhythmias are the known risk factors for SCD[17, 136]. The estimated incidence rate of SCD in infants, children, adolescents, and young adults is about 1.3 to 8.5 per 100,000 patient/years [137] but it still costs to thousands life per year. Sudden infant death syndrome accounting for approximately 10% of the crib death is believed to be due to cardiac arrhythmia or long QT syndrome [138]. A study suggest that out of 158 deaths of American athletes, 30% were due to hypertrophic cardiomyopathy and 13% due to abnormal blood circulation, 10% due to increased cardiac mass due to cardiomyopathy [139]. Another study suggest 20% death due to CAD and 10% deaths due to right ventricular cardiomyopathy/ dysplasia in young population [140]. Patients suffering from SCD with normal heart or without any cardiac disease history, on autopsy show structural abnormalities. Sudden unexplained deaths are also a major concern in epidemiology of SCD and careful post-mortem and histological examination can play a vital role [17]. In a study with 270 autopsies 55 were found to have structural heart disease and a specific cause for death were found in 180 cases with 65% having CAD, 14% with congenital anomalies and 11% with myocarditis. Left

This method demonstrates impaired relaxation and filling because it delivers straight measurement of ventricular diastolic pressure. But, the balance of benefit, harm and cost can debate against its use to diagnose diastolic dysfunction. The other technique which can be used to diagnose diastolic heart failure is Doppler echocardiography. Doppler echocardiography is used to assess cardiac diastolic function, which can confirm the diagnosis of diastolic heart failure. For example, according to the online article, “Diastolic heart failure: challenges of diagnosis and treatment” states “echocardiographic measurement of tau, the time constant of left ventricular pressure decay during isovolunteric relaxation, can be performed to assess left ventricular stiffness.” Doppler echocardiography plays an important role to evaluate the characteristic of diastolic Trans-mitral-value- blood flow. Doppler echocardiography helps to measure the peak velocities of blood flow during early diastolic filling (E wave) and atrial contraction (A wave) and then ratio is calculated. When the heart is working normal, the early filling E-wave velocity is greater than the A-wave velocity and E to A wave ratio is 1.5. But, in diastolic dysfunction, this correlation reverses, because stiffness increases and the relaxation of heart occur slowly and E to A wave ratio decreases to 1.0. Also, as the diastolic

According to Wung et al. (2013), there are two types of inheritable cardiac disease; channelopathies such as Brugada, long QT syndrome and short QT syndrome, and cardiomyopathies such as arrhythmogenic right ventricular cardiomyopathy. While channelopathies may be identified by characteristic ECG irregularities, some of these disorders may not manifest typical symptoms in genetic carriers (Wung et al., 2013). Genetic testing for those with vague symptoms such as syncope, arrhythmias of the ventricles, or those who have a history of SCD in the family may identify an underlying condition (Wung et al., 2013). If a genetic condition is identified in the affected person, the specific mutations can be identified with genetic testing and be used to identify at-risk family members who may then undergo cardiac monitoring, treatment and counseling

“Following The Trail of Broken Hearts” by David Epstein published on December 10, 2007 really opens your eyes to the fact that there are more medical problems then sometimes we think or know about. We hear about the big ones like cancer, diabetes, and high cholesterol but, what about the not well known diseases that are taking more lives than other diseases combined? This article opens up and recognizes one of those diseases, HCM or Hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is a primary disease of the myocardium (the muscle of the heart) in which a portion of the myocardium ishypertrophied (thickened) without any obvious cause. It is perhaps best known as a leading cause of sudden cardiac death in young athletes.[7] The occurrence of hypertrophic cardiomyopathy is a significant cause of sudden unexpected cardiac death in any age group and as a cause of disabling cardiac symptoms. Younger people are likely to have a more severe form of hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is a primary disease of the myocardium (the muscle of the heart) in which a portion of the myocardium ishypertrophied (thickened) without any obvious cause. It is perhaps best known as a leading cause of sudden cardiac death in young athletes.[7] The occurrence of hypertrophic cardiomyopathy is a significant cause of sudden unexpected cardiac death in any age group and as a cause of disabling cardiac symptoms. Younger people are likely to have a more severe form of hypertrophic cardiomyopathy.

This paper will discuss Cardiac Hypertrophy. There are two types that will be discussed as far as the physiological and pathological hypertrophy, which was taken from three articles discussed in class and other scholarly articles.

Akashi, K. Nakazawa, M. Sakakibara, F. Miyake, H. Koike, K. Sasaka 2003). Echocardiography with left ventricle pathognomonic wall motion abnormalities such as the base contracting normally but the remaining walls being severely hypokinetic is a key diagnostic feature in takotsubo cardiomyopathy. ECG findings are often confused with those found during an acute anterior wall myocardial infarction because they mimic classic ST-segment elevation, T-wave inversion or QT-interval prolongation (Azzarelli S, Galassi AR, Amico F, Giacoppo M, Argentino V, Tomasello SD, Tamburino C, Fiscella A., 2006), making it difficult to diagnose upon presentation. A coronary angiogram, typically used to evaluate individuals with left ventricular dysfunction, will not reveal any significant blockages. Myocardial enzymes rise only moderately at worst, which may be easily overlooked during diagnosis. Blood tests will show increased white blood cell count, to believe bacterial infections are present although the results will usually be negative.