The Analysis Of Diagnosis And Treatment Of84Patients With Hypertrophic Cardiomyopathy

Background:Hypertrophic cardiomyopathy is a common inherited cardiovascular disease, with diverse phenotypic and genetic expression,clinical presentation,and nature history. It’s most common and the most harmful complications are sudden cardiac death,hemodynamic disorder because of left ventricular tract obstruction,atrial fibrillation and stroke,progressive heart failure.Methods and Results:This research selects84patients who were hospitalized in cardiology department and whose discharge diagnosis are hypertrophic cardiomyopathy from2010-1-1to2014-12-31. There are53males and31females with an average age of60.21±13.80years old. The diagnosis of74patients(88.10%) are clear through echocardiogram and left ventricular angiography.3patients(3.57%)have a clear family history of hypertrophic cardiomyopathy.1patient(1.19%) has a family history of sudden cardiac death with both parents and an elder sister.1patient has the secondary prevention indication of SCD,and implanted an ICD.7patients have the primary prevention indication of SCD,2patients (28.57%) had implanted an ICD,2patients (28.57%) rejected after careful consideration,the other3patients were not mentioned in the medical records. There are17hypertrophic obstructive cardiomyopathy patients. 16patients performed echocardiogram and coronary and left ventricular angiography of which12patients got the similar results from the two inspections.9patients have the indication for septal alcohol ablation.4patients (44.44%) performed the SAA, and whose degree of left ventricular tract obstruction are obviously decreased,4patients (44.44%) rejected after careful consideration,1patient was not mentioned in the medical records.19HCM patients complicated atrial fibrillation or atrial flutter,9patients used oral anticoagulation with VKA,5patients used aspirin antiplatelet therapy.15patients used adrenergic beta receptor blocker to control the ventricular rate,5patients used amiodarone to antiarrhythmic therapy,2patients used digoxin to to control the ventricular rate.2paroxysmal atrial fibrillation patients performed radiofrequency ablation.There are18non-obstructive hypertrophic cardiomyopathy patients with cardiac insufficiency (NYHA degree III-IV).7patients were complicated with atrial fibrillation,4patients were complicated with severe coronary heart disease, the other7patients were simply caused by NHOCM, among them2patients’LVEF were less than50%.13patients used adrenergic beta receptor blocker to improve prognosis,11patients used ACEI or ARB medication,10patients used MRA to improve prognosis.8patients used loop diuretic to improve symptoms.51patients with the symptoms of chest pain or chest tightness performed coronary angiography.26patients coronary angiography were normal,11patients had severe coronary disease,7patients had slight coronary disease,8patients had the left anterior descending artery myocardial bridge.Conclusion:The diagnosis and treatment for hypertrophic cardiomyopathy of the cardiology department is broadly in line with the HCM guideline.