All are true about hyperophic obstructive cardiomyopathyexcept-
Correct Answer: Anterior leaflet movement is delayed
Description: Obstructive or non-obstructive Depending on whether the distoion of normal hea anatomy causes an obstruction of the outflow of blood from the left ventricle of the hea, HCM can be classified as obstructive or non-obstructive. The obstructive variant of HCM, hyperophic obstructive cardiomyopathy (HOCM), has also historically been known as idiopathic hyperophic subaoic stenosis (IHSS) and asymmetric septal hyperophy (ASH). Another, non-obstructive variant of HCM is apical hyperophic cardiomyopathy, also called Yamaguchi Syndrome or Yamaguchi Hyperophy, first described in individuals of Japanese descent. Hyperophic cardiomyopathy (HCM) is a condition in which a poion of the hea becomes thickened without an obvious cause.This results in the hea being less able to pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shoness of breath. It may also result in chest pain or fainting.Complications include hea failure, an irregular heabeat, and sudden cardiac death. It is often due to mutations in ceain genes involved with making hea muscle proteins. Other causes may include Fabry disease, Friedreich's ataxia, and ceain medications such as tacrolimus.It is a type of cardiomyopathy, a group of diseases that primarily affects the hea muscle. Diagnosis often involves an electrocardiogram, echocardiogram, and stress testing. Genetic testing may also be done Upon cardiac catheterization, catheters can be placed in the left ventricle and the ascending aoa, to measure the pressure difference between these structures. In normal individuals, during ventricular systole, the pressure in the ascending aoa and the left ventricle will equalize, and the aoic valve is open. In individuals with aoic stenosis or with HCM with an outflow tract gradient, there will be a pressure gradient (difference) between the left ventricle and the aoa, with the left ventricular pressure higher than the aoic pressure. This gradient represents the degree of obstruction that has to be overcome in order to eject blood from the left ventricle. The Brockenbrough-Braunwald-Morrow sign is observed in individuals with HCM with outflow tract gradient. This sign can be used to differentiate HCM from aoic stenosis. In individuals with aoic stenosis, after a premature ventricular contraction (PVC), the following ventricular contraction will be more forceful, and the pressure generated in the left ventricle will be higher. Because of the fixed obstruction that the stenotic aoic valve represents, the post-PVC ascending aoic pressure will increase as well. In individuals with HCM, however, the degree of obstruction will increase more than the force of contraction will increase in the post-PVC beat. The result of this is that the left ventricular pressure increases and the ascending aoic pressure decreases, with an increase in the LVOT gradient. While the Brockenbrough-Braunwald-Morrow sign is most dramatically demonstrated using simultaneous intra-cardiac and intra-aoic catheters, it can be seen on routine physical examination as a decrease in the pulse pressure in the post-PVC beat in individuals with HCM Ref Davidson 23rd edition pg 456
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