Apical Hypertrophic Cardiomyopathy Analysis

Apical hypertrophic cardiomyopathy (AHCM) hypertrophic cardiomyopathy are a special type, less common clinical, ECG changes and coronary heart disease have similarities, the majority of patients with no symptoms or the lack of specific symptoms and signs, easily lead to misdiagnosis and misdiagnosis.

AHCM confined to apical hypertrophy, the former apical wall is particularly evident, the most thick in addition to up to 14-32mm. Most occurred in the male, often a family history, is now considered are autosomal dominant genetic disease, sarcomere contractile protein gene mutations are the main pathogenic factors.

The early symptoms of mild disease, in late may have heart palpitations, chest tightness, chest pain, exertional dyspnea and hair force performance.

This disease diagnosed mainly based on ECG, echocardiography and left ventricular angiography. Echocardiography is currently the most widely and was considered the most AHCM has diagnostic value of screening methods, the specificity at 90%. Its diagnostic criteria: 1. Hypertrophy confined to the left ventricular myocardium papillary muscles below apex, free wall thickness> 16mm. 2. Septal and left ventricular cavity expanding.

Misdiagnosed because: 1. Echocardiography inherent shortcoming: because of restrictions by the window, as well as in patients with obesity or adjacent lung tissue, such as the impact of echocardiography can not happen when enough of the echo may be missed. 2. Not timely echocardiography and left ventricular angiography.

AHCM because no dynamic left ventricular outflow and cardiac infarction interior pressure gradient exists, the impact on cardiac hemodynamics less favorable prognosis, the annual fatality rate of only 0.1 percent, 15-year survival rate of 95%.

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Pulmonary cryptococcosis misdiagnosed as lung cancer

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Pulmonary cryptococcosis misdiagnosed as lung cancer

Pulmonary cryptococcosis is a rare disease, with solitary pulmonary shadow as the main imaging features, and easily misdiagnosed as lung cancer, diagnosed to be based on pathological examination(infective-endocarditis.com).
Susceptible: Pulmonary cryptococcosis mainly by respiratory tract infection caused by Cryptococcus, which is disseminated disease, no significant regional and ethnic differences. High-risk groups include: 1. Long-term use of glucocorticoid; 2. AIDS; 3. Organ Transplant; 4. Malignancies; 5. Chronic lung disease; 6. Diabetes. The disease often occurs in adults, more men than women, children rarely incidence. Many have pigeon feces, soil history of exposure to mycophenolate, sputum culture or India ink staining can be found in cryptococcosis. In recent years, without basic medical history and pigeon dung, a history of exposure to mycophenolate territories were gradually increased morbidity, hidden morbidity also increased, and the lesion is located in many peripheral subpleural lung, it fiberoptic bronchoscopy positive rate low.
Misdiagnosis: 1. The lack of characteristic clinical manifestations. 2. The relevant checks before the surgery is not comprehensive(infective-endocarditis.com).
Clinical manifestations: Of this disease without the characteristic signs and symptoms are often difficult to diagnose certain. Symptoms is often mild, can have low-grade fever, cough, expectoration, chest pain, such as respiratory symptoms, or with fatigue, night sweats, weight loss and other systemic symptoms, severe acute respiratory time failure. On 1 / 3 ring cover asymptomatic, many in the medical examination found. AIDS have impaired immune function, such as basic diseases most obvious symptoms may be complicated by adult respiratory distress syndrome, and easily could be combined extra-pulmonary Cryptococcus infection to the central nervous system, skin and urinary system involvement common(infective-endocarditis.com).
Diagnostic tool: imaging diagnosis, laboratory examination, pathological examination.
Prevention of complications after surgery: guard against post-operative complications, including wound infection, empyema, bronchial pleural crate, etc.. The most important complications and higher mortality are cryptococcal meningitis, there were reports of surgical resection of pulmonary cryptococcosis in patients after surgery do not use anti-fungal treatment, one year after easily cryptococcal meningitis. Therefore, when the diagnosis of pulmonary cryptococcosis, even when no symptoms of central nervous system infection, but also the need for routine examination of cerebrospinal fluid after surgery should be supplemented by antifungal therapy, in order to reduce the chance of systemic dissemination. Pulmonary recurrence after surgery can be medical treatment, surgical indications have to be positive again surgery(infective-endocarditis.com).

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