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Hypertrophic cardiomyopathy (HCM, or HOCM when obstructive) is a condition in which muscle tissues of the heart become thickened without an obvious cause. [8] The parts of the heart most commonly affected are the interventricular septum and the ventricles . [ 10 ]
The Cornell voltage criteria [13] for the ECG diagnosis of LVH involve measurement of the sum of the R wave in lead aVL and the S wave in lead V 3. The Cornell criteria for LVH are: S in V 3 + R in aVL > 28 mm (men) S in V 3 + R in aVL > 20 mm (women) The Romhilt-Estes point score system ("diagnostic" >5 points; "probable" 4 points):
Hypertrophic cardiomyopathy screening is an assessment and testing to detect hypertrophic cardiomyopathy (HCM). [ 1 ] [ 2 ] It is a way of identifying HCM in immediate relatives of family members diagnosed with HCM, and athletes as part of a sports medical . [ 3 ]
According to one study, it has a sensitivity of 65% and specificity of 96% in HOCM. [11] Valsalva maneuver, as well as standing, decrease venous return to the heart. As a result, this decreases left ventricular filling. With HOCM, the outflow obstruction increases with a decrease in preload. This will increase the loudness of the murmur with ...
The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. The ECG will show a QS or rS complex in lead V1 and a monophasic R wave in lead I.
The fourth heart sound or S 4 is an extra heart sound that occurs during late diastole, immediately before the normal two "lub-dub" heart sounds (S 1 and S 2).It occurs just after atrial contraction and immediately before the systolic S 1 and is caused by the atria contracting forcefully in an effort to overcome an abnormally stiff or hypertrophic ventricle.
People who have a normal ECG and who are able to exercise, for example, do not merit routine imaging. [13] Imaging tests such as stress radionuclide myocardial perfusion imaging or stress echocardiography can confirm a diagnosis when a person's history, physical exam, ECG and cardiac biomarkers suggest the likelihood of a problem. [13]
Still, the real predictive value of these findings is questioned. Late potentials may be found in 0-10% of normal volunteers. When used as a prognostic factor for the development of ventricular tachycardia , they have a sensitivity of 72% and a specificity of 75%, yielding a positive predictive value of 20% and a negative predictive value of 20%.