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Hypertrophic Cardiomyopathy Summary

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I chose to summarize this review article to understand the reasons behind exercising a patient with hypertrophic cardiomyopathy (HCM). Prior to the reading, my knowledge of stress echos only covered the bases of diagnosing coronary artery disease. This review focuses on the patient’s subjective complaints and its correlation with sudden death from HCM.

It’s common for us to see patient with HCM and to perform Valsalva maneuvers to check for LVOT obstruction with increased velocities. However, a new understanding leads me to believe that performing a Valsalva maneuver at rest may not always cause an obstruction of the LVOT. In this review study, to get a better understanding of patients with HCM, they now stress the patients to evaluate LVOT obstruction, mitral regurgitation, left ventricle asynergy and diastolic function.

An exercise stress test will be ordered when a patient with HCM is complaining of dyspnea, syncope and chest pain during exertion. Although these complaints are subjective, preforming a stress test can give physician’s objective finding towards the extent of the patients HCM. These objective findings can include systolic anterior motion of the mitral valve (SAM), LVOTO and EKG …show more content…
Prior to stressing, there will be a resting EKG taken and baseline echo picture of the PLAX, SAX, 4ch and 2ch. While exercising, the patient will need to reach target heart rate before post exercising evaluations can begin. Target heart is 85% of the patient’s maximum heart rate. Max. HR of the patient equals 220- their age, take that answer and multiply it by .85 to calculate the target HR. Once the patient has reach their target heart rate, the sonographer needs to start the post exercise pictures and Doppler samples as quick as possible. Exercise stress test can be dangerous. It’s critical to have a crash cart, nurse and supervising physician on hand for the safety of the

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