It's a small world, Dr. Boris......I consider John to be a good friend as well, had a lot of dinners with his family and my husband's been fishing with him! We have also both loved and owned Great Pyrenees. Take care!
So, I was at Landstuhl from 1997 to 2000, and knew of Dr. Creech, but never met him. I was at Keesler as a resident when Dr. Brownlee was there. I spent a lot of time with him, did a research project with him, and count him as one of my mentors and friends--he's such a great person.
I know you are busy, Dr. Boris and I do not want to take away from thefamilies on this forum, but I just read your profile and saw you were at Keesler AFB. Did you know Goerge Russell Creech or John Brownlee? Creech took care of my girls at Lakenheath for several years and Brownlee took care of my daughter at Wilford Hall. My husband was a 20 year vet and we spent the last 10 years stationed at Randolph AFB......all the best doctors always seem to leave the Air Force!
It would still be considered primary, as a secondary hypertrophy is felt to be "secondary" to another condition like hypertension, aortic stenosis, coarctation of the aorta, etc.
Hello again Dr Boris,
Thank you so much for the reply you sent back to me. I have to admit that I was pretty stunned to hear of your patient with the HCM and PRKAG2 gene. It was our understanding that this gene causes the combination of HCM with electrical issues, specifically WPW. So does one consider their patient to have Primary or Secondary HCM if they have this mutation? I. again thank you for your response.
Dear Grendslori,
Interestingly, I follow a patient with hypertrophic cardiomyopathy (HCM) and a PRKAG2 mutation at CHOP, as well. There is variability in the expression, or what would be called the clinical picture. As well, not all patients with HCM and PRKAG2 mutations have conduction abnormalities, such as Wolff-Parkinson-White syndrome or Mahaim fibers. We do recommend genetic testing for patients with HCM, as approximately 65-70% of mutations are able to be determined. If it is positive, it is helpful to then look for the same mutation in first-degree relatives (i.e. parents, siblings, offspring). This can then be helpful from a follow-up standpoint. Unfortunately, there has been no demonstration that knowing the actual mutation is predictive of outcomes nor of response to medications, unfortunately.