The hyperkinetic heart syndrome is an idiopathic cardiac condition that involves heart overactivity and hypercontractility, augmented cardiac output and elevated pulse pressure, without an underlying cardiac pathology [1] [2].

It is primarily diagnosed in patients aged 7-48 years and patients are mostly asymptomatic and in good health [3] [4]. Exercise tolerance is normal, and, due to the absence of symptoms, patients are usually referred for a cardiological evaluation for an auscultated heart murmur. The hyperkinetic heart symptom was first described by R. Gorlin in 1959.

A minority of the patients may report palpitations or fatigue, due to co-existing conditions, such as mitral stenosis or congestive cardiomyopathy [4].

• Heart Disease

  Thus, ischemic heart disease, valvular heart disease, arrhythmias, and conduction defects have been assigned a high priority reflected by their location in the first few sections of this book. [books.google.de]

  The term refers to a heart disease that is cased by the narrowing of the arteries that supply blood to the heart. Heart attack resulted when the blood supply is cut off. [connection.ebscohost.com]

  Endocardial fibroelastosis; a factor in heart disease of obscure etiology: a study of 20 autopsied cases in children and adults. [ncbi.nlm.nih.gov]

  ( I13.- ) heart disease specified as rheumatic ( I00 - I09 ) Complications and ill-defined descriptions of heart disease Approximate Synonyms Abscess of heart Heart disease due to ionizing radiation Papillary muscle disorder Radiation heart disease due [icd10data.com]

According to the first comprehensive study carried out by Goblin and Brachfeld [5], the hyperkinetic heart syndrome is difficult to diagnose and constitutes a diagnosis made on the basis of clinical suspicion.

Cardiac auscultation reveals a murmur that can be:

• Mid-systolic heard along the left sternal border
• Grade 3 pansystolic murmur over the right precordium
• Grade 3 basal systolic
• Grade 2 systolic
• Grade 4 systolic

During the physical examination, the patients are found to be normotensive or slightly hypertensive, even though an extreme rise in systolic blood pressure is not expected. A diffuse apical impulse and wide pulse pressure are also detected.

An electrocardiogram usually reveals left ventricular hypertrophy or a right ventricular overload with no apparent cause; a right bundle branch block and a prolonged QT interval may be found to co-exist as well. The cold pressor test is generally expected to be positive, illustrating reduced peripheral resistance. Plain radiographs frequently show an enlarged ventricular shadow.

Right heart catheterization provides a diagnostic clue that greatly aids in the diagnosis of the hyperkinetic heart syndrome: it can detect an increased cardiac output, a finding shared by all patients with the disorder. It can also help to differentiate the hyperkinetic heart syndrome from a ventricular septal defect.

Additional blood tests involving a complete blood count and biochemical markers usually reveal no abnormalities, or the abnormalities that are detected are unrelated to the hyperkinetic heart syndrome.

Long term treatment of the hyperkinetic heart syndrome with propranolol. [moh-it.pure.elsevier.com]

Some studies of the known hypertensive popu lation indicate that one-half or less are receiving adequate treatment, and, of those on therapy, only half have their high blood pressure satisfactorily controlled. [books.google.com]

Comparison of bisoprolol and diazepam in the treatment of cardiac neurosis [5]. Long-term treatment of hyperkinetic heart syndrome with propranolol [6]. Mepindolol sulfate in the hyperkinetic heart syndrome [7]. [wikigenes.org]

Long-term treatment of hyperkinetic heart syndrome with propranolol. Am J Med Sci 1975;270:465–474. Google Scholar 20. Rimon R, Kampman R, Viukari M. Propranolol in the treatment of neurocirculatory asthenia: An open pilot study. [link.springer.com]

Uncomplicated idiopathic hyperkinetic heart syndrome appears to have an excellent long-term prognosis. [ncbi.nlm.nih.gov]

Also they found a “benign short-term and 20-year prognosis in the majority of patients with the idiopathic hyperkinetic heart syndrome” with occasions of regression, although they recommended beta-blockade particularly for patients with hypertension [onlinejacc.org]

In pregnancy, it has an excellent prognosis with prompt multidisciplinary management. [oapublishinglondon.com]

References and Links LITFL CCC — Prognosis After Cardiac Arrest CCC — Post-cardiac arrest care CCC — Targeted temperature management (TTM) after cardiac arrest Journal articles Mongardon N, Dumas F, Ricome S, Grimaldi D, Hissem T, Pène F, Cariou A. [lifeinthefastlane.com]

"Four-Year Recurrence Rate and Prognosis of the Apical Ballooning Syndrome". J Amer Coll Card. 50 (5): 448–52. doi : 10.1016/j.jacc.2007.03.050. [en.wikipedia.org]

The hyperkinetic heart syndrome also referred to as hyperkinetic heart disease or idiopathic hyperkinetic state, is a cardiac disorder of unknown etiology, that leads to increased cardiac output, overactivity and responds positively to the administration [symptoma.com]

Endocardial fibroelastosis; a factor in heart disease of obscure etiology: a study of 20 autopsied cases in children and adults. [ncbi.nlm.nih.gov]

Table 3 lists clinical features suggesting specific etiologies. 2 Table 3: Clinical Features Suggesting Specific Etiologies Reflex syncope Absence of heart disease Longstanding and recurrent syncope After unexpected pain, smell or sight After prolonged [clevelandclinicmeded.com]

Both hereditary and environmental factors play a role in its etiology. [lecturio.com]

Although the exact etiology of this dysfunction is unknown, the leading hypothesis suggests that increased circulating catecholamines lead to a diffuse cardiac micro vascular vasospasm leading to cardiac wall motion abnormalities and impaired cardiac [ispub.com]

Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation. Circulation. 2008 Dec 2;118(23):2452-83. [lifeinthefastlane.com]

License: CC BY 2.5 Definition and Epidemiology of Congenital Heart Disease Congenital heart diseases (CHD) are structural heart defects present since birth. [lecturio.com]

[…] presentation, it typically improves within the first few days and normalises within the first few months. [1] [13] [14] [15] Although infrequent, recurrence of the syndrome has been reported and seems to be associated with the nature of the trigger. [1] [19] Epidemiology [en.wikipedia.org]

Epidemiology of reflex syncope. Clin Auton Res 2004; 14(suppl 1):I/9–I/17. Abi-Samra F, Maloney JD, Fouad-Tarazi FM, Castle LW. The usefulness of head-up tilt testing and hemodynamic investigations in the workup of syncope of unknown origin. [clevelandclinicmeded.com]

One would surmise, on the basis of the aforementioned, that PH and “hyperkinetic heart syndrome” might have something in common, if they do not represent the same pathophysiological entity. [onlinejacc.org]

Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation. Circulation. 2008 Dec 2;118(23):2452-83. [lifeinthefastlane.com]

"Tako-Tsubo cardiomyopathy: new insights into the possible underlying pathophysiology". European Journal of Echocardiography. 7 (1): 53–61. doi : 10.1016/j.euje.2005.08.003. [en.wikipedia.org]

Further research is required into the reason why it affects women more than men and also into the exact pathophysiology underpinning this cardiomyopathy. [inmo.ie]

Morbidity is particularly high in the elderly, and is associated with loss of confidence, fear of falling, depression, fractures, and institutionalization. 2 Back to Top Physiology and Pathophysiology The pathophysiology of syncope involves the interaction [clevelandclinicmeded.com]

Prevention, based largely on altering behaviors that contribute to this chronic disease, is now as important a goal as is treatment of those already afflicted. [books.google.de]

Far too few people realize what the risks are and what can be done to prevent these risks even in the countries where pro grams in hypertension research are active and the full significance of hyper tension is best understood. [books.google.com]

It is also great in preventing cardiac neurosis. It is popular among bodybuilders since it helps them sleep faster and have ample rest for the next day. [polemeds.org]

Angina pectoris (prevention of attacks). [healthdirect.gov.au]

Dizziness and, in particular, syncope during exercise may result from cardiac disorders that prevent the normal rise (or an actual fall) in cardiac output. [quizlet.com]

1. Gorlin R, Brachfeld N, Turner JD, Messer JV, Salazar E. The idiopathic high cardiac output state. J Clin Invest, 38 (1959), pp. 2144–2153.
2. R. Gorlin. The hyperkinetic heart syndrome. JAMA, 182 (1962), pp. 823–829
3. Gillum RF, Teichholz LE, Herman MV, Gorlin R. The idiopathic hyperkinetic heart syndrome: clinical course and long-term prognosis. Am Heart J, 102 (1981), pp. 728–734.
4. Guazzi M, Polese A, Magrini F, Fiorentini C, Olivari MT. Long-term treatment of hyperkinetic heart syndrome with propranolol. Am J Med Sci. 1975 Nov-Dec;270(3):465-74.
5. Brachfeld N, Gorlin R. Idiopathic hyperkinetic state: a new clinical syndrome. Br Heart J, 22 (1960), pp. 353–360.