The standard echocardiogram is the most commonly used technique to identify the wall thickness for hypertrophic cardiomyopathy. Because hypertrophic cardiomyopathy may develop as the patient ages, it is important that echocardiography be repeated through the patient’s lifetime in order to identify whether the individual has hypertrophic cardiomyopathy, once a family member has this identified.
The echocardiogram is one of the most important tests in understanding your heart and diagnosing hypertrophic cardiomyopathy. It is an ultrasound scan of your heart (the same ultrasound used to take pictures of babies in the womb). The ultrasound allows us to view your heart beating in real time.
Some patients with hypertrophic cardiomyopathy have a build-up of pressure as the blood tries to leave the heart, sometimes called an outflow tract gradient (this is why hypertrophic cardiomyopathy is sometimes called hypertrophic obstructive cardiomyopathy). This build-up of pressure (gradient) can be monitored by echocardiography.
In nearly all patients diagnosed with hypertrophic cardiomyopathy, the echocardiogram shows increased wall thickness. The degree of wall thickness ranges greatly from being relatively minimal (13-15 mm) to massive (30 mm or greater).
The normal range, depending on the echocardiographic laboratory, is usually up to a maximum of 11 to12 mm. Although thickness of the heart is used as the primary method of making this diagnosis, there are other causes of thickening of the ventricle. The most common cause is elevated blood pressure, or hypertension. Individuals with hypertension may even develop a relatively severe degree of thickening.
Therefore, if the patient is found to have thickening of the wall, assessment of blood pressure is important to determine whether the patient has hypertension or high blood pressure. Individuals with thickening of the wall due to high blood pressure are not felt to have hypertrophic cardiomyopathy, despite the increased wall thickness. This is because the high blood pressure itself causes the wall thickening, rather than there being an inherited cause.
In individuals with thickening of the heart due to high blood pressure, there is not felt to be an increased risk of other heart abnormalities, such as serious heart rhythm problems such as ventricular tachycardia.
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