Hypertrophic cardiomyopathy hemodynamics

Hypertrophic cardiomyopathy a primary myocardial disorder of sacromeric proteins with an autosomal dominant pattern of inheritance is characterized by asymmetric hypertrophy of the septum with or without dynamic obstruction of the outflow tract (1,2), The prevalence in the general population is estimated as 1 500 and it is the most common monogenic cardiac disorder, Annual mortality in an unselected population is reported to be about I % to 2%, and sudden death is the most common cause, Sudden death is assumed to be due to idiopathic ventricular arrhythmias, but hemodynamic factors and myocardial ischemia may be involved as well. 

Veselka J, Duchonova R, Prochazkova S, et al. Effects of varying ethanol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy on early hemodynamic changes. Am J Cardiol 2005 95 675-678. 

Cardiovascular Cardiac arrest has been reported after nasal infiltration with lidocaine and adrenaline in a patient with a hypophysoma and a previously undiagnosed hypertrophic cardiomyopathy [26 ]. This emphasizes that absorbed adjuncts, such as adrenaline, can be hazardous and should be considered in the differential diagnosis if hemodynamic instability occurs after infiltration of a local anesthetic with adrenaline. 

I Veselka J, Prochazkova S, Duchonova R et al. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy Lower alcohol dose reduces size of infarction and has comparable hemodynamic and clinical outcome. Catheter Cardiovasc Interv 2004 63 231-235. 

---