Talk:Hypertrophic cardiomyopathy

message: Actually the septal that is infused with alcohol may not be the first septal perforator.  What is done in experienced centers is an echocardiogram (I'm not sure if it is a TTE or TEE) at the time of the angiogram.  The septal artery is occluded with a balloon and echo contrast (or agitated saline?) is injected distally into the septal perforator.  The wall motion is then observed via echo to see if the gradient improves and also to see what portion of the septum will be affected by the ablation.  Will have to find a reference or two to add this to the article. Ksheka 14:13, 30 November 2006 (UTC)
thread_title: Alcohol septal ablation

message: Who first identified hypertrophic cardiomyopathy as a disease? —Temporaluser 07:22, 19 March 2008
:Belated thanks for the question. Now Donald Teare's landmark 1958 paper is highlighted in the article. —Patrug (talk) 10:34, 6 February 2017 (UTC)
replies: text: It's doubtful that anyone has a reliable record for this. For some reassurance, the first paragraph of the article now summarizes: "In most patients, HCM is associated with little or no disability and normal life expectancy." —Patrug (talk) 10:34, 6 February 2017 (UTC)
thread_title:  Historical information? 

message: Should there not be an etymology for medical terms? At least people are made aware of the origin of the medical terms and what they mean. For example Hypertrophic from the Greek hyper + trophy and cardiomyopathy from the Greek kardia + mus + pathy.....1.120.132.240 (talk)  —Preceding undated comment added 07:26, 13 September 2013 (UTC)
replies: text: Thanks. The first sentence of the article now summarizes: "Hypertrophic cardiomyopathy (HCM) is a disease in which a portion of the myocardium (heart muscle) is hypertrophic (enlarged) without any obvious cause, creating functional impairment of the heart." —Patrug (talk) 19:28, 6 February 2017 (UTC)
thread_title:  Etymology? 

message: doi:10.1016/S0140-6736(16)31321-6
—JFW | T@lk 09:32, 2 December 2016 (UTC)
thread_title:  Lancet journal reference links 

message: doi:10.1016/j.amjmed.2016.09.015 not all HCM causes septic hypertrophy. A proportion progresses to CCF. JFW | T@lk 21:13, 22 January 2017 (UTC)
thread_title:  HCM sine obstructio 

message: The following is unsourced or almost entirely unsourced. Moved here per WP:PRESERVE.  Per WP:BURDEN, don't restore without finding MEDRS sources, checking the content against them, and citing them. 
;Pathophysiology
Individuals with HCM have some degree of left ventricular hypertrophy. Usually this is an asymmetric hypertrophy, involving the inter-ventricular septum, and is known as asymmetric septal hypertrophy. This is in contrast to the concentric hypertrophy seen in aortic stenosis or hypertension. About two-thirds of individuals with HCM have asymmetric septal hypertrophy.
About 25% of individuals with HCM demonstrate an obstruction to the outflow of blood from the left ventricle during rest. In about 70% of patients, however, the obstruction can be provoked under certain conditions. This is known as dynamic outflow obstruction because the degree of obstruction is variable and is dependent on the loading conditions (ventricular filling and arterial blood pressure) and the contractility state of the left ventricle.
Myocardial hypertrophy and extracellular fibrosis predispose to increased left ventricular stiffness, which in concert with compromised cellular energetics and abnormal calcium handling, leads to diastolic dysfunction manifested as dyspnea and exercise intolerance.
The altered structure of the coronary vessels and increased diastolic pressure (reduced blood supply), together with the hypertrophy and the outflow tract obstruction (increased demand), cause myocardial ischemia that is manifested as angina and may be responsible for the triggering of ventricular arrhythmias.
In about 30% of patients, there are abnormal vascular responses and inability to increase systolic blood pressure during exercise. This is attributed to exaggerated cardiac inhibitory reflexes initiated by increased myocardial wall stress and to elevated levels of vasodilating substances (natriuretic peptides).
;Physical examination 
 Differentiating hypertrophic cardiomyopathy and valvular aortic stenosis
                     	Aortic stenosis              	Hypertrophic cardiomyopathy
Echocardiography          	Echocardiography             	Echocardiography
Aortic valve calcification	Common                       	No
Dilated ascending aorta   	Common                       	Rare
Ventricular hypertrophy   	Concentric LVH               	Asymmetric, often involving the septum
Physical examination      	Physical examination         	Physical examination
Murmur of AI              	Common                       	No
Pulse pressure after PVC  	Increased                    	Decreased
Valsalva maneuver         	Decreased intensity of murmur	Increased intensity of murmur
Carotid pulsation         	Normal or tardus et parvus   	Brisk, jerky, or bisferiens pulse (a collapse of the pulse followed by a secondary rise)
The physical findings of HCM are associated with the dynamic outflow obstruction that is often present with this disease.
Upon auscultation, the heart murmur will sound similar to the murmur of aortic stenosis. However, a murmur due to HCM will increase in intensity with any maneuver that decreases the volume of blood in the left ventricle (such as standing abruptly or the strain phase of a Valsalva maneuver). Administration of amyl nitrite will also accentuate the murmur by decreasing venous return to the heart. Classically, the murmur is also loudest at the left parasternal edge, 4th intercostal space, rather than in the aortic area.
If dynamic outflow obstruction exists, physical examination findings that can be elicited include the pulsus bisferiens and the double apical impulse with each ventricular contraction. These findings, when present, can help differentiate HCM from aortic stenosis. In addition, if the individual has premature ventricular contractions (PVCs), the change in the carotid pulse intensity in the beat after the PVC can help differentiate HCM from aortic stenosis. In individuals with HCM, the pulse pressure will decrease in the beat after the PVC (Brockenbrough–Braunwald–Morrow sign), while in aortic stenosis, the pulse pressure will increase.  However, post-PVC left ventricular systolic pressure and murmur intensity increase in both aortic stenosis as well as HCM.
-- Jytdog (talk) 06:09, 19 October 2017 (UTC)
thread_title:  unsourced 

message: Too much of this is written as advice to doctors, telling them how to treat patients. This needs to be revised per MEDMOS, addressed to everybody. Jytdog (talk) 01:12, 23 October 2017 (UTC)
thread_title:  Needs a rewrite per MEDMOS 

message: Feline hypertrophic cardiomyopathy - do you have plans for this part of the page?Sofia Hanås (SLU) (talk) 14:05, 15 May 2020 (UTC)
replies: text: Wikipedia is written by volunteers who rarely announce their plans for the future. I see you are a subject expert, so why dont you be WP:BOLD and if you have material that is reliably sourced, (see WP:RS and WP:MEDRS) why not add it yourself. I see that you are pretty new here, so I'll leave a welcome message on your Talk page with some hopefully useful links for beginners. If you are worried about doing something wrong in a new environment, dont be, there are lots of experienced editors who will help. -Roxy the effin dog . wooF 14:19, 15 May 2020 (UTC)
replies: text: Thank you Roxy the dog.Sofia Hanås (SLU) (talk) 14:27, 15 May 2020 (UTC)
thread_title:  Feline hypertrophic cardiomyopathy 

message: Can this condition be caused by external causes, such as drugs, chemicals, poisons, and also infections like bacteria, viruses, etc...?107.195.106.201 (talk) 18:40, 15 April 2022 (UTC)
replies: text: It is genetic, inherited. Have you read the article? -Roxy  the grumpy dog. wooF 18:47, 15 April 2022 (UTC)
replies: text: Wikipedia does not give medical advice.  - FlightTime (open channel) 18:51, 15 April 2022 (UTC)
replies: text: I'm curious as to why you posted to this thread, User:FlightTime. -Roxy  the grumpy dog. wooF 20:22, 15 April 2022 (UTC)
replies: text: Simple, I wanted to. Why?  - FlightTime (open channel) 20:27, 15 April 2022 (UTC)
replies: text: Because nobody is asking for, or giving, medical advice here. -Roxy  the grumpy dog. wooF 11:39, 16 April 2022 (UTC)
thread_title:  "External" causes? 

message: doi:10.1016/j.jacc.2021.11.021 JFW | T@lk 12:35, 26 January 2023 (UTC)
thread_title:  State of the art review