Hypertrophic cardiomyopathy ischemia

Hypertrophic Cardiomyopathy Microchapters
Home
Patient Information
Overview
Classification
Pathophysiology Genetics Outflow Obstruction Diastolic Dysfunction Ischemia Arrhythmogenesis Anatomic Abnormalities Histopathology Gross Pathology
Epidemiology and Demographics
Screening
Natural History, Complications and Prognosis
Risk Factors For Sudden Death
Differentiating Hypertrophic Cardiomyopathy from other Diseases
Diagnosis
History and Symptoms
Physical Examination
Electrocardiogram
Chest X Ray
MRI
CT
Echocardiography
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy Treatment Strategy Supportive Therapy Pharmacotherapy Guidelines
Invasive Therapy Alcohol Septal Ablation Septal Myectomy Ventricular Pacing Automatic Implantable Cardiac Defibrillator (AICD) Placement Guidelines
Cardiac transplantation
Special Scenario Asymptomatic Patients Management During Childhood Activities/Circumstances to Avoid Management During Pregnancy
Hypertrophic cardiomyopathy ischemia On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hypertrophic cardiomyopathy ischemia
CDC on Hypertrophic cardiomyopathy ischemia
Hypertrophic cardiomyopathy ischemia in the news
Blogs on Hypertrophic cardiomyopathy ischemia</small>
Directions to Hospitals Treating Hypertrophic cardiomyopathy
Risk calculators and risk factors for Hypertrophic cardiomyopathy ischemia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There is extensive periarteriolar fibrosis that results in microvascular dysfunction and an impairment in coronary flow reserve in patients with hypertrophic obstructive cardiomyopathy.

Histopathology

Compared to normal arterioles on the left, the arterioles from a patient with hyertension (middle) show moderate periarteriolar thickening and fibrosis. Shown on the right is a patient with HCM in which there is even more signficant periarteriolar thickening and fibrosis. This thickening of the wall of the intramyocardial arterioles leads to an increased wall/lumen ratio, subendocardial ischemia and impaired coronary flow reserve. Patients who subsequently died in one series had abnormal coronary flow reserve on PET scanning at baseline indicating that ischemia may play a role, at least in part, in subsequent mortality.

• 

  Normal arteriole

• 

  Hypertensive arteriole with wall thickening and myocyte hypertrophy

• 

  Arteriole in HCM patient with periarteriole fibrosis and thicknening