What cardiomyopathy is seen in long standing hypertension?

Etorphine

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    yes.

    Primary HTN/Secondary HTN (due to renal atherosclerosis)-->Increased peripheral pressure, independent of heart disease--> Increased afterload for the heart --> Cardiac compensation through concentric hypertrophy --> hypertrophic cardiomyopathy

    please correct/add information
     
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    SpecterGT260

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      Hypertrophy is not by itself a cardiomyopathy. The two shouldn't be linked. You get hypertrophy in hypertension. HCM is a genetic thing that kills young athletes.

      remember that a cardiomyopathy is an intrinsic defect with the myocytes. In hypertrophic cardiomyopathy you get irregularly arranged myocytes which causes them to hypertrophy in order to maintain ejection fraction. In hypertension you have regular myocytes that have a normal response of hypertrophy to increased afterload.
       
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      voicesinmyhead

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        remember that a cardiomyopathy is an intrinsic defect with the myocytes. In hypertrophic cardiomyopathy you get irregularly arranged myocytes which causes them to hypertrophy in order to maintain ejection fraction. In hypertension you have regular myocytes that have a normal response of hypertrophy to increased afterload.

        which is what i thought too, and was going to correct anastomosis, but then i found this:

        https://www.inkling.com/read/usmle-step-2-ck-kaplan-2nd/chapter-3/hypertrophic-cardiomyopathy

        :confused:
         
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        SpecterGT260

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            Hypertrophy is not by itself a cardiomyopathy. The two shouldn't be linked. You get hypertrophy in hypertension. HCM is a genetic thing that kills young athletes.

            remember that a cardiomyopathy is an intrinsic defect with the myocytes. In hypertrophic cardiomyopathy you get irregularly arranged myocytes which causes them to hypertrophy in order to maintain ejection fraction. In hypertension you have regular myocytes that have a normal response of hypertrophy to increased afterload.

            HOCM is what you're talking about in young athletes with sudden arrest. And HCM encompasses both anyhow. I'm not sure what you mean by "the two shouldn't be linked".
             

            Transposony

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              There are too many acronyms. Its listed in the book as "hereditary hypertrophic cardiomyopathy". No O :shrug:
              That used to be the case but to avoid confusion they are now called HOCM (hereditary) & HCM (everything else). Source-MTB.
              However, I agree that even now some people still refer to both of them HCM.
               

              Instatewaiter

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                Is prolonged hypertension causative of any kind of cardiomyopathy?

                I was told it was hypertrophic, but hypertrophic Cardiomyopathy is asymmetrical, and hypertension causes symmetrical hypertrophy.

                Any thoughts?

                Prolonged hypertension causes hypertrophy. It is not always concentric but for the boards it probably will be. Regardless it can cause heart failure (not systolic heart failure). With severe hypertrophy you get a thick ventricle which causes problems with diastolic filling. Thus, you get diastolic dysfunction. When you get volume overloaded this is called heart failure with preserved ejection fraction (HFpEF). It is the same pathophysiology as restrictive cardiomyopathy.

                To explain further, your heart can squeeze well, it just doesn't fill properly because the ventricle is too stiff to fill well during diastole. So your cardiac output is low because your stroke volume is low because your ventricle cannot fill.

                HCM and hypertrophy from hypertension are separate entities. In real life, they can mimic each other. The hypertrophy from HoCM causes obstruction because the anterior leaflet of the mitral valve presses up against the septum blocking the LV outflow tract via so called systolic anterior motion (SAM). In hypertension, with enough hypertrophy the septum becomes thick and on the echo you see similar findings of SAM.


                HOCM is what you're talking about in young athletes with sudden arrest. And HCM encompasses both anyhow. I'm not sure what you mean by "the two shouldn't be linked".


                When someone says hypertrophic cardiomyopathy they don't mean a hypertensive heart because in most instances hypertensive hypertrophy is not the same as HCM.
                 

                Instatewaiter

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                  That used to be the case but to avoid confusion they are now called HOCM (hereditary) & HCM (everything else). Source-MTB.
                  However, I agree that even now some people still refer to both of them HCM.


                  HCM is still the genetic form, it just doesn't have the obstruction. In this instance, there is the same kind of muscular disarray in HoCM but the mitral leaflet does not completely obstruct the LV outflow.
                   

                  SpecterGT260

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                    HCM is still the genetic form, it just doesn't have the obstruction. In this instance, there is the same kind of muscular disarray in HoCM but the mitral leaflet does not completely obstruct the LV outflow.

                    That's.... irritating. I don't see any need for the distinction. They are the same disease process with differing degrees of severity. It would be kinda like having SCD, but it's SoCD if you autosplenectomize (may.... may not be a real word but I hope you catch my meaning)
                     

                    Instatewaiter

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                      That's.... irritating. I don't see any need for the distinction. They are the same disease process with differing degrees of severity. It would be kinda like having SCD, but it's SoCD if you autosplenectomize (may.... may not be a real word but I hope you catch my meaning)

                      As distinctions go in medicine, this is one of the more apt ones. There is a big distinction in how they are treated. Without obstruction there is no reason to do surgery and essentially no risk of sudden death unless there is a lot of scar on MRI.
                       
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