Hypertrophic cardiomyopathy ischemia

Hypertrophic Cardiomyopathy Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypertrophic Cardiomyopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypertrophic cardiomyopathy ischemia On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypertrophic cardiomyopathy ischemia

CDC on Hypertrophic cardiomyopathy ischemia

Hypertrophic cardiomyopathy ischemia in the news

Blogs on Hypertrophic cardiomyopathy ischemia

Directions to Hospitals Treating Hypertrophic cardiomyopathy

Risk calculators and risk factors for Hypertrophic cardiomyopathy ischemia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

[edit | edit source]

There is extensive periarteriolar fibrosis that results in microvascular dysfunction and an impairment in coronary flow reserve in patients with hypertrophic obstructive cardiomyopathy.

## Histopathology

[edit | edit source]

Compared to normal arterioles on the left, the arterioles from a patient with hyertension (middle) show moderate periarteriolar thickening and fibrosis. Shown on the right is a patient with HCM in which there is even more signficant periarteriolar thickening and fibrosis. This thickening of the wall of the intramyocardial arterioles leads to an increased wall/lumen ratio, subendocardial ischemia and impaired coronary flow reserve[1][2]. Patients who subsequently died in one series had abnormal coronary flow reserve on PET scanning at baseline indicating that ischemia may play a role, at least in part, in subsequent mortality.

* Normal arteriole

* Hypertensive arteriole with wall thickening and myocyte hypertrophy

* Arteriole in HCM patient with periarteriole fibrosis and thicknening

## References

[edit | edit source]

1. ↑ Lorenzoni R, Gistri R, Cecchi F, Olivotto I, Chiriatti G, Elliott P; et al. (1998). "Coronary vasodilator reserve is impaired in patients with hypertrophic cardiomyopathy and left ventricular dysfunction". Am Heart J. 136 (6): 972–81. PMID 9842009.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
2. ↑ Choudhury L, Elliott P, Rimoldi O, Ryan M, Lammertsma AA, Boyd H; et al. (1999). "Transmural myocardial blood flow distribution in hypertrophic cardiomyopathy and effect of treatment". Basic Res Cardiol. 94 (1): 49–59. PMID 10097830.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)