Echocardiography in Hypertrophic Cardiomyopathy
10/2/2017
Echocardiography in Hypertrophic Cardiomyopathy
Linda D. Gillam, MD, MPH, FACC, FASE Chair, Department of Cardiovascular Medicine Morristown Medical Center/Atlantic Health System Chanin T Mast Center for Hypertrophic Cardiomyopathy
No disclosures
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10/2/2017
Goals
? Understand the echocardiographic features of HCM
? Understand the importance of the mitral valve in HCM
? Learn imaging tips including the use of contrast
? Recognize SAM
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In Hypertrophic Cardiomyopathy, Echocardiography can ....
? Establish the diagnosis/characterize the disease
? Define patterns of hypertrophy (LV and RV) ? Assess systolic function ? Assess diastolic function ? Quantitate obstruction (at rest and with maneuvers) ? Assess concomitant mitral valve abnormalities and regurgitation ? Risk stratify ? Differentiate from athlete's heart ? Differentiate from restrictive CM
? Help guide myectomy and alcohol ablation ? Stress testing in HCM
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Defining "Hypertrophy"
? Wall thickness (any segment) >15 mm (?12 mm women)
? Septal to posterior wall thickness ratio >1.3 in normotensive pts. or 1.5 in hypertensive pts.
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Define patterns of hypertrophy
Presence of hypertrophy and its distribution
? Classically asymmetric but can be in any pattern and at any location, including the right ventricle
? Although septal predominance is more common, hypertrophy can be isolated to the LV free wall or apex
? RV hypertrophy (may be in any location) is rare
? >5 mm subcostal window
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Asymmetric Septal Hypertrophy
Asymmetric septal hypertrophy (with SAM)
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Asymmetric septal hypertrophy
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Multiple wall hypertrophy
10/2/2017
Apical lateral wall hypertrophy
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