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Gradient Measurement
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Gradient Measurement

Son diagnosed with WPW, Hypertrophic Cardiomyopathy right side ventricle age 14 in 1996 & gradient measurent was 4.8mm; 2001 measurement is 5.2mm. Is this considered an excessive thickening?
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Dear gail,

Do you mean cm?  The normal septum is about 1 cm thick and thickening is considered present when it is greater than 2 cm.  Greater than 4cm is considered severe thickening. Often if there is this much thickening and a gradient surgery to reduce the thickness is considered.  If he is not already seeing a specialist in HOCM I would recommend you seek one out.  Dr. Harry Lever here is a world expert in this condition and I would highly recommend him if you wish to come to Cleveland.  Below is some general information about HOCM.

IHSS (Idiopathic Hypertrophic Subaortic Stenosis), now commonly referred to as HOCM or HCM (Hypertrophic Obstructive CardioMyopathy), is a congenital (meaning that it runs in families) condition that results in thickening of the heart muscle (hypertrophy), a increased pressure gradient (obstruction) across the outflow tract and a cardiomyopathy (abnormal function of the heart muscle).  

Symptoms of HOCM include shortness of breath, lightheadedness, fainting and chest pain. Some patients experience cardiac rhythm disturbances which in some cases may lead to sudden death.   Due to this possibility patients with this condition are advised to avoid competitive sports (normal activity levels are OK). The obstruction to blood flow from the left ventricle increases the work the ventricle must do, and a heart murmur may be heard.

The treatment of HOCM may be several fold.  Medications, such as beta blockers and calcium channel blockers, are often given to attempt to decrease the workload of the heart.  Surgery may be recommended in patients with very high pressure gradients in the heart.  In a septal myectomy he surgeon goes into the heart and removes part of the muscle that is obstructing the blood outflow. A alternative procedure that is being developed here and at several other centers that avoids the need for surgery.  A catheter (tiny tube) is threaded through the leg to the heart and the blood vessels that supply the thickened heart muscle are identified and then closed off with a solution of alcohol.  This results in a thinning of that particular area of the heart.  Not all patients are eligible for this procedure and there are benefits and risks to both procedures.


Additional web sites with information about HOCM are listed below.

http://www.americanheart.org/Heart_and_Stroke_A_Z_Guide/cmyopa.html

HOCM Support groups

http://www.kanter.com/hcm/

http://www3.bravenet.com/forum/show.asp?userid=qf175386

National Organization for rare diseases

http://www.rarediseases.org/

HOCM of Canada

http://www.cadvision.com/hcmac/hcmac.html

Mayo Clinic HOCM Clinic

http://www.mayo.edu/cv/wwwpg_cv/hocm_cln/hocm.htm

Article on septal ablation

http://www-east.elsevier.com/jac/3102/jac5431fla.htm

More info

http://www.arrhythmia.com/patient/other/HCM.html


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