Re: Hypertrophic Cardiomyopathy

Posted By CCF CARDIO MD sc on January 07, 1998 at 11:05:16:

In Reply to: Hypertrophic Cardiomyopathy posted by Luc on December 30, 1997 at 19:32:53:







: Dear Doctor,
I am a Belgium male 32 years old and I have a hypertrophic cardiomiopathy There is a septal and apical hypertrophy the biopsy of the heart shows myocardial disarray.I have much problems from ischemi in my heart the Myocard scan of my heart shows there are lots of pleases thats shows reversible and irreversible ischemi in the septum aria anteroseptale,inferolaterale wall .I have liver and spleen enlargemend,shortness of breath,light headedness my meds are now Zestril 20mg,one beta bloker Demitone,syscor 5mg ( nitroglycerin) it seem that my medications do not help me, My EF is between the 35-39.
What can there be dun for me, please give me some advice.







































   _


Dear Luc
I am sorry to hear about your predicament. Your condition appears to be more complex that isolated HCM because as your scans suggest that is impaired blood flow to area of the heart that are not affected by the hypertrophy. The other thing that is concerning is the fact that your ejection fraction is below what is expected in HCM. HCM tends to be associated with a hyperdynamic heart with ejection fractions above 60-65%.  The fact that your ejection fraction is below 40% could imply that your HCM is at a very advanced stage or that there are other conditions associated or not that may be affecting your heart function such as a chronically leaking heart valve or occlusions in the heart arteries. The SOB and enlarged spleen may suggest fluid overload and a degree of biventricular failure. My suggestion to you is to have a complete evaluation of your condition with an echocardiogram so that the extent of your HCM and any other associated condition may be evaluated. If your doctors think that there may be a degree of coronary artery narrowing they could consider a cardiac catheterization to have this fully evaluated and possibly treated.  Until a clear understanding of your disease process is obtained I cannot  safely advice you on treatment strategies. There are  however other options that could be considered for HCM such as a surgical procedure called myomectomy, possible septal artery immobilization and even pacemaker placement to change the dynamics of your hearts contraction. I will not add any more information at this point. If you are interested there have been numerous questions on HCM/IHSS in this forum which you may refer to.
If you have any further questions or would like to visit the Cleveland Clinic to be seen by one of our cardiologists specializing in this field please feel free to call 1-800-CCF- CARE
Information in this forum is intended for general purposes only, specific diagnosis and treatment strategies should be reserved for physicians directly involved in patient care.