Movement disorders
E Glucksman in MCQs in Neurology and Neurosurgery for Medical Students, 2022
This chapter provides that the themed presentation encourages quick, focused study and detailed answers aid comprehension and encourages familiarity with each topic with essential diagrams, colour images and sample MRIs. Vitamin B12 deficiency can cause subacute combined degeneration of the cord; this affects the dorsal columns that carry proprioception and vibration. Friedreich’s ataxia affects the young. Paraneoplastic cerebellar degeneration is an autoimmune disease where antibodies are directed against Purkinje cells in the cerebellum. It is often associated with lung, breast and ovarian cancers and Hodgkin’s lymphoma. Patients commonly present with cerebellar signs. They can also have foot deformities (high-arched feet or pes cavus), diabetes mellitus and hypertrophic cardiomyopathy (a usual cause of death in these patients).
Aetiology
Gregory YH Lip in Atrial Fibrillation in Practice, 2020
In developed countries, hypertensive heart disease is the most common underlying disorder in patients with atrial fibrillation (AF). In the Framingham study, hypertension was considered to be the most common cause of AF, being present in over 50% of subjects. There is a high prevalence of coronary artery disease (CAD) in the population, and thus CAD is commonly stated as a frequent cause of AF. AF occurs frequently in association with heart failure, and the presence of the latter can result in significant haemodynamic disturbance as well as an increase in the risk of stroke and thromboembolism. Rheumatic heart disease is infrequent in developed countries, but worldwide, rheumatic valve disease is an important cause of AF. The development of AF in patients with hypertrophic cardiomyopathy, who are likely to have diastolic dysfunction, may result in haemodynamic compromise. Any pericardial disease can cause AF.
Station 3: Cardiology
Saira Ghafur, Parminder K Judge, Richard Kitchen, Samuel Blows, Fiona Moss in The MRCP PACES Handbook, 2017
Aortic stenosis is an ejection systolic murmur which is loudest over the aortic area and radiates to the carotids. The cardiac examination takes time. In valvular heart disease, pay attention to signs other than the murmur (e.g. character of the peripheral pulse and apex beat and association of differences in pulse pressure). It is possible that the doctors may know the diagnosis before they listen to the chest. Aortic regurgitation is an early diastolic murmur which is heard loudest over the left sternal edge with the patient sitting forward. Hypertrophic cardiomyopathy (HCM) is associated with an ejection systolic murmur heard loudest at the left sternal edge. Key clinical findings are a bifid jerky pulse, a double apical impulse and a palpable thrill. This is an autosomal dominant inherited condition which is associated with sudden cardiac death. Mitral stenosis is a mid-diastolic murmur which is heard loudest at the apex in the left lateral position.
Infantile Hypertrophic Cardiomyopathy and Bronchopneumonia as Causes of an Unexpected Death in an 11-Month-Old Child
Published in Fetal and Pediatric Pathology, 2020
Francesco Lupariello, Giancarlo Di Vella, Giovanni Botta
Background: Hypertrophic cardiomyopathy is characterized by intrinsic myocardial hypertrophy that is not consequent to hemodynamic stimuli. Infantile hypertrophic cardiomyopathy (
The role of imaging in the diagnosis and management of hypertrophic cardiomyopathy
Published in Expert Review of Cardiovascular Therapy, 2016
Adaya Weissler-Snir, Andrew Crean, Harry Rakowski
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy, affecting approximately 1:500 people. As the yield of genetic testing is only about 35–60%, the diagnosis of HCM is still clinical and based on the demonstration of unexplained and usually asymmetric left ventricular (LV) hypertrophy by imaging modalities. In the past, echocardiography was the sole imaging modality used for the diagnosis and management of HCM. However, in recent years other imaging modalities such as cardiac magnetic resonance have played a major role in the diagnosis, management and risk stratification of HCM, particularly when the location of left ventricular hypertrophy is atypical (apex, lateral wall) and when the echocardiographic imaging is sub-optimal. However, the most unique contribution of cardiac magnetic resonance is the quantification of myocardial fibrosis. Exercise stress echocardiography is the preferred provocative test for the assessment of LV outflow tract obstruction, which is detected only on provocation in one-third of the patients.
Surgical management of obstructive hypertrophic cardiomyopathy: the gold standard
Published in Expert Review of Cardiovascular Therapy, 2008
Morgan L Brown, Hartzell V Schaff
While medication is the first line of therapy in obstructive hypertrophic cardiomyopathy, patients who have symptoms refractory to medical treatment or asymptomatic patients with high resting gradients (≥30 mmHg) may require septal myectomy. Surgical septal myectomy can be performed safely, with excellent survival, relief from symptoms and low morbidity. Alcohol septal ablation is an alternative to surgical treatment, but late outcomes are uncertain. Although both methods of septal reduction relieve left ventricular outflow tract gradients and improve functional status, the need for permanent pacing appears higher with alcohol ablation compared with surgical myectomy. As our understanding of obstructive hypertrophic cardiomyopathy continues to grow, the indications for intervention will evolve. In our practice, septal myectomy remains the gold standard for treatment of obstructive hypertrophic cardiomyopathy.
Related Knowledge Centers
- Cardiomyopathies
- Congestive Heart Failure
- Endocardial Fibroelastosis
- Left Ventricular Hypertrophy
- Takotsubo Cardiomyopathy
- Restrictive Cardiomyopathy
- Subvalvular Aortic Stenosis