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Biventricular Hypertrophy


Presentation

  • The aim of the present study was to determine whether pathogenic mutations were present in families with mitochondrial cardiomyopathy that presented during adolescence.[ncbi.nlm.nih.gov]
Abdominal Obesity
  • In the whole population, the most common component of the MS other than high BP was abdominal obesity (63.2%) followed by high fasting glucose (46.2%), hypertriglyceridemia (29.8%) and low high-density lipoprotein cholesterol (15.1%).[nature.com]
Heart Disease
  • In families in which parental mutations are known, preimplantation (where ethically and legally feasible) or prenatal genetic screening should be adopted because: (1) neonatal HCM in genetic heterozygosity is potentially lethal and (2) heart disease is[ncbi.nlm.nih.gov]
  • The diphasic QRS type of electrocardiogram in congenital heart disease . Am Heart J; 1937, 13: 202-206. Elliott LP, Anderson RC, Tuna N, Adams P, Neufeld HN. Complete Transposition of the Great Vessels : II. An Electrocardiographic Analysis.[lifeinthefastlane.com]
  • I51.5 Myocardial degeneration I51.7 Cardiomegaly I51.8 Other ill-defined heart diseases I51.81 Takotsubo syndrome I51.89 Other ill-defined heart diseases I51.9 Heart disease, unspecified I52 Other heart disorders in diseases classified elsewhere I60[icd10data.com]
  • Atrial Enlargement : Atrial enlargement/hypertrophy occurs in conditions like chronic obstructive pulmonary disease, rheumatic heart disease or congenital heart disease with pulmonary hypertension etc.[yourarticlelibrary.com]
  • This case illustrates a highly atypical presentation of FAP, with advanced heart disease and mild neurologic impairment, relatively late onset and no family history.[elsevier.pt]

Workup

Right Axis Deviation
  • Right axis deviation. Tall biphasic QRS complexes in multiple leads. Deep S waves in V5-6. In the presence of RVH – Additional signs indicating LVH : Tall R waves and deep S waves in V2-5. QRS amplitude 50 mm.[lifeinthefastlane.com]
  • Encyclopedia An electrocardiographic finding suggestive of enlargement or thickening of both ventricles, with a combination of findings which are related to LVH and RVH, such as voltage criteria for LVH in the presence of marked right axis deviation.[tititudorancea.com]
  • Biventricular hypertrophy ECG In case the ECG or other examinations suggest left ventricular hypertrophy (LVH) , one should suspect concomitant right ventricular hypertrophy (RVH) if the following ECG criteria are presented: Right axis deviation ( 90[ecgwaves.com]
  • ., R in aVL 11 mm; note wide QRS/T angle) Example 2: (ESTES Criteria: 3 points for voltage in V5, 3 points for ST-T changes) Right Ventricular Hypertrophy General ECG features include: Right axis deviation ( 90 degrees) Tall R-waves in RV leads; deep[ecg.utah.edu]
  • The persistent S waves in lateral precordial leads and the right axis deviation are other findings in RVH.[frca.co.uk]
P Pulmonale
  • Deep S-wave in V5 or V6 ( 6 mm) Large RS complexes in multiple leads P pulmonale Figure 1. ECG changes seen in left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH).[ecgwaves.com]
  • P pulmonale: It is reflected by the presence of tall- and peaked P waves in leads II, III and aVF. The amplitude is more than 2.5 mm. It is called P pulmonale because it occurs frequently due to pulmonary hypertension (Fig. 5.1a, b). 2.[yourarticlelibrary.com]
  • Right atrial abnormality increases the amplitude of the initial P-wave forces, contrasting with increase in the later P-wave forces that can result from left atrial abnormality (pseudo-P pulmonale).[ahajournals.org]
Electrocardiogram Change
  • There was no relationship between electrocardiogram changes and Doppler tricuspid regurgitation gradient. CONCLUSION.[pediatrics.aappublications.org]
  • AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram, part V: electrocardiogram changes associated with cardiac chamber hypertrophy: a scientific statement from the American Heart Association Electrocardiography[ahajournals.org]

Treatment

  • Circulation ‏ الصفحة 510 - conditions for which there is evidence and/or general agreement that a given procedure or treatment is beneficial, useful, and effective. ‏[books.google.com]
  • Results showed that after an average treatment time of 4.8 years, treatment that was based on losartan was better than treatment based on atenolol for reducing stroke risk.[guidelines.hypertension.ca]
  • We are here to help and encourage you in reaching your treatment goals.[heart.org]
  • It combines specialized centers for the treatment of cancers, cardiovascular diseases, neurological and orthopedic disorders, as well as an Ophthalmology Centre and a Fertility Center.[humanitas.net]

Prognosis

  • The majority of patients with mild hypertrophy are at low risk and can be reassured regarding their prognosis.[nejm.org]
  • An independent predictor of prognosis in essential hypertension. Hypertension 1994; 24:793. 8. Devereux, RB, Pickering, TG, Harshfield, GA, et al.[ispub.com]
  • Heart failure with preserved left ventricular systolic function: epidemiology, clinical characteristics, and prognosis . J Am Coll Cardiol. 2004; 43:317–327. 2. Lam C, Donal E, Kraigher-Krainer E, et al.[geriatricsandgerontology.it]
  • […] case is a reminder of the diagnostic limitations of endomyocardial biopsy and of the value of genetic testing in patients with cardiomyopathies, 9 which in this instance was crucial not only to establish a definite diagnosis, but also to outline the prognosis[elsevier.pt]

Etiology

  • Etiology The causes of cardiomyopathies are varied ( Table 2 ). 1 Dilated cardiomyopathy in adults is most commonly caused by CAD (ischemic cardiomyopathy) and hypertension, although viral myocarditis, valvular disease, and genetic predisposition may[aafp.org]
  • Recent advances in the etiology, diagnosis, and treatment of myocarditis and cardiomyopathies in children. Curr Opinion Pediatrics 1995;7:587-594. Spirito et al.[mottchildren.org]
  • Hypertrophic cardiomyopathy is characterized by left ventricular hypertrophy (wall thickness 12-15 mm; normal wall thickness is 12 mm or less, measured during diastole) without obvious etiology.[radiopaedia.org]
  • […] general adult population Prevalence of HCM in children is unknown, but population based studies report an annual incidence of 0.3 to 0.5 per 100,000 Occurs in all ethnic groups and equally in both sexes Most affected individuals remain unidentified Etiology[pathologyoutlines.com]

Epidemiology

  • Antiplatelet Drugs Pleiotropic effects LDL receptor Re-Entry Diastole Normal coronary flow Supply / Demand Imbalance Preload, afterload & contractility Coronary Perfusion Pressure Left ventricular hypertrophy Ejection Fraction & Endsystolic Volume Clinical Epidemiology[profmontage.com.au]
  • Epidemiology and preserved ejection fraction . Eur J Heart Fail. 2011; 13:18–28. 3. Steinberg Ba, Zhao X, Heidenreich Pa, et al.[geriatricsandgerontology.it]
  • Conclusion LV mass estimation and LVH diagnosis role in cardiovascular disease management is based on epidemiological research and also on clinical grounds.[cardiovascularultrasound.biomedcentral.com]
  • Epidemiology and causes-specific outcome of hypertrophic cardiomyopathy in children. Circulation. 2007;115:773-81. Medline 1885-5857/ 2011 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved[revespcardiol.org]
  • The epidemiology of heart failure: The Framingham study. J Am Coll Cardiol 1993; 22 (Supplement A): 6A - 13A.)[ispub.com]
Sex distribution
Age distribution

Pathophysiology

  • Gender Differences in LV mass due to gender, independent of questions related to body size, may have pathophysiological implications.[cardiovascularultrasound.biomedcentral.com]
  • […] disease expression Sporadic HCM can reflect an inaccurate family history, incomplete penetrance or a de novo mutation which may be heritable Patients who are genotype positive may be phenotypically negative without overt hypertrophy (subclinical HCM) Pathophysiology[pathologyoutlines.com]
  • Inotropic agents like dopamine and dobutamine are contraindicated as they are prone to decrease ventricular size and further obstruct cardiac outflow. [10] The pathophysiology of cardiac hypertrophy in infant of diabetic mother is explained by Pederson[mjdrdypu.org]
  • Genetic mutations can be identified in approximately 60% of patients; these are most common in genes that encode proteins of the cardiac sarcomere. [ 5 ] Management The pathophysiology of HCM is complex, leading to significant variability in clinical[patient.info]
  • First, this study provides clinical data to support a recently proposed paradigm that identifies distinct pathophysiologies for HFrEF and HFpEF (24).[heartfailure.onlinejacc.org]

Prevention

  • Hypertension Canada’s 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children. Can J Cardiol. Background 1.[guidelines.hypertension.ca]
  • Patients with multiple risk factors for sudden death benefit from implantable cardioverter defibrillator (ICD) implantation for primary prevention.[patient.info]
  • However, before this happens, there are several things you can do the help lower your risk factors and prevent further cardiac muscle structure changes.[belmarrahealth.com]
  • SBE can usually be prevented by taking an antibiotic before these procedures. Exercise guidelines: An individual exercise program is best planned with the doctor so that all factors can be included.[mottchildren.org]
  • Young patients with extreme hypertrophy, even those with few or no symptoms, appear to be at substantial long-term risk and deserve consideration for interventions to prevent sudden death.[nejm.org]

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