(精选)【英文课件精品课件】Echocardiography教学课件.pptVIP

Hypertrophic Cardiomyopathies Hypertrophic Cardiomyopathies Hypertrophic Cardiomyopathies No evidence of outflow obstruction at rest. Maneuvers Spontaneous PVC results in an increased LV contraction on the post PVC beat. Valsalva maneuver Amyl nitrate Hypertrophic Cardiomyopathies Mitral valve abnormalities Increased length and surface area of MV especially the AMVL. Excessive degree of coaptation with the coaptation place displaced posteriorly. Anomalous papillary muscle anatomy with direction insertion of the papillary muscle into the leaflet. Hypertrophic Cardiomyopathies Differential Diagnosis Hypertension with hyper dynamic concentrically hypertrophy of the ventricle. Hypertrophic Cardiomyopathies Hypertrophic Cardiomyopathies Hypertrophic Cardiomyopathy Autosomal dominant Abnormalities in the Beta myosin heavy chain. Predominant Features Asymmetric hypertrophy of the LV Normal ventricular systolic function Impaired LV diastolic function +/- Subaortic dynamic obstruction Hypertrophic Cardiomyopathies Clinical Features High risk of sudden death Symptoms of angina Exercise intolerance Syncope Systolic murmur Hypertrophic Cardiomyopathies Type Feature I Hypertrophy confined to Anterior segment of the IVS II Hypertrophy confined to Anterior and Inferior segments of the IVS III Extensive hypertrophy of LV with sparing of the basal segment of the posterior wall. IV Apical hypertrophy Hypertrophic Cardiomyopathies Hypertrophic Cardiomyopathies The apical pattern of hypertrophy is associated with an inverted precordial T waves on the EKG Hypertrophic Cardiomyopathies The common feature of all of these hypertrophy patterns is normal thickness of the basal posterior LV wall. Hypertrophic Cardiomyopathies Subaortic obstruction Caused by apposition of AMVL against the hypertrophied septum. Dynamic obstruction Occurs in mid – late systole Hypertrophic Cardiomyopathies Hypertrophic Cardiomyopathies Subaortic obstruction Maximu