Pre PACES Podcast #37 Hypertrophic cardiomyopathy
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Jun 19, 2022 Dr. Omar Asghar, a consultant cardiologist specializing in inherited cardiac conditions, discusses hypertrophic cardiomyopathy (HCM) and its variants, including obstructive and non-obstructive types. He dives into genetic implications and how to spot red flags during examinations. Omar details diagnostic investigations, risk stratification, and treatment options ranging from lifestyle advice to invasive procedures. The conversation also includes a fun quiz where Omar reveals his passion for Liverpool FC, showcasing his versatile expertise beyond cardiology!
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HCM Is Common And Clinically Important
- Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease with prevalence ~1:200–1:500.
- It often causes sudden death in young people and presents in varied phenotypes beyond classical obstruction.
Obstruction Drives Prognosis And Phenotypes
- Obstruction (LVOT) defines hypertrophic obstructive cardiomyopathy (HOCM) and carries worse prognosis and management complexity.
- HCM phenotypes include asymmetric septal, mid-ventricular, concentric and apical patterns, some without obstruction.
Genetics Is Important But Often Negative
- Only ~20–30% of patients with a classical HCM phenotype are genotype-positive for sarcomeric mutations.
- Genotype-positive but phenotype-negative individuals can still suffer cardiac events, so genetics matters for family screening and risk.