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Hypertrophic Obstructive Cardiomyopathy #HOCM🚧
#Symptoms
Profound exertional dyspnea
#Imaging
▪️SAM/LVOT obstruction #whyCMR
▪️Classic #Doppler🗡#echofirst
#Hemodynamics
▪️Brockenbrough-Braunwald-Morrow sign, explained
#Treatment
▪️Alcohol🍷septal ablation #RadialFirst
#Symptoms
Profound exertional dyspnea
#Imaging
▪️SAM/LVOT obstruction #whyCMR
▪️Classic #Doppler🗡#echofirst
#Hemodynamics
▪️Brockenbrough-Braunwald-Morrow sign, explained
#Treatment
▪️Alcohol🍷septal ablation #RadialFirst
🙏 @hopkinsheart @JonResar @RaniKHasan @kman8585 @DoctorLatina for unlocking these concepts for me!
@PushpaShivaram @AnastasiaSMihai @HeartOTXHeartMD
@DavidWienerMD @DrJayMohan @DxRxEdu @MasriAhmadMD @onco_cardiology @NadeenFaza @dr_chirumamilla @mirvatalasnag @TheVeggieMD
@PushpaShivaram @AnastasiaSMihai @HeartOTXHeartMD
@DavidWienerMD @DrJayMohan @DxRxEdu @MasriAhmadMD @onco_cardiology @NadeenFaza @dr_chirumamilla @mirvatalasnag @TheVeggieMD
Question:
Why wouldn’t more filling time⏱ prior to post PVC beat lead to less obstruction, less gradient, & ↑ arterial pressure?
After all, doesn’t ↑LV volume in #HCM ↓gradient and improve symptoms?
Cornerstone tx is hydration/💊s that ↑ diastolic filling time ...
Why wouldn’t more filling time⏱ prior to post PVC beat lead to less obstruction, less gradient, & ↑ arterial pressure?
After all, doesn’t ↑LV volume in #HCM ↓gradient and improve symptoms?
Cornerstone tx is hydration/💊s that ↑ diastolic filling time ...
Answer: @iamritu @alenghat &others explained:
In #HCM, while post PVC diastolic filling time increases, the benefit of
↑LV volume is outweighed by ↑contractility via intracellular calcium🥛& #FrankStarlingCurve
Net result: ↑obstruction, ↓arterial pulse pressure.
In #HCM, while post PVC diastolic filling time increases, the benefit of
↑LV volume is outweighed by ↑contractility via intracellular calcium🥛& #FrankStarlingCurve
Net result: ↑obstruction, ↓arterial pulse pressure.
I should also shout📢 out my clinical/academic mentor @EdKasper3 who got me energized about #HCM &guides me on treatment of patients we encounter in our clinic.
The historical perspective & debate about #obstruction in HCM is fascinating and always a treat to hear about.
The historical perspective & debate about #obstruction in HCM is fascinating and always a treat to hear about.
Regarding #Treatment
This particular case utilized alcohol septal ablation which worked beautifully for our patient.
Of course, surgical myectomy😷 is another option & can be more preferable depending on the case, having a great surgeon around
Especially w/ MV pathology
This particular case utilized alcohol septal ablation which worked beautifully for our patient.
Of course, surgical myectomy😷 is another option & can be more preferable depending on the case, having a great surgeon around
Especially w/ MV pathology
