Hypertrophic Cardiomyopathy—Past, Present and Future

Figures

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  Figure 1. Brockenbrough sign after a premature ventricular contraction (PVC) in HCM (Hypertrophic cardiomyopathy). Pulse pressure, as recorded in the femoral artery, decreases in the post-extrasystolic beat (circled) while intracavity pressure in the LV (Left ventricle) increases due to greater obstruction in the LVOT (Left ventricular outflow tract). (Reproduced from [12] with permission).

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  Figure 2. (A) Schematic demonstrating how left ventricular hypertrophy (LVH) with unfavourable mitral valve anatomy may result in obstruction of the left ventricular outflow tract. Echocardiography allows high quality imaging of the left ventricular outflow tract due to systolic anterior motion of the anterior mitral valve leaflet; (B) Abnormal motion of the mitral valve is well demonstrated on M-mode echocardiography. This may result in high velocities through the LVOT seen on continuous wave Doppler imaging as seen in (C). LA—Left atrium. MV—Mitral valve. LV—Left ventricle. LVOT—Left ventricular outflow tract, LVH—Left ventricular hypertrophy, Ao—Aort.

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  Figure 3. Hypertrophic cardiomyopathy imaged using cardiovascular magnetic resonance (CMR). (A) Short axis through the heart and asymmetrical left ventricular hypertrophy (starred); (B) Four chamber view of the heart; (C) Late gadolinium imaging showing patchy fibrosis of the hypertrophied area; (D) Same heart in the long axis. LV—Left ventricle, RV—Right ventricle, LA—Left atrium, RA—Right atrium.