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Introduction disease
Hypertrophic cardiomyopathy is characterized by cardiac hypertrophy. According to whether the left ventricular outflow tract obstruction can be divided into obstructive and non-obstructive hypertrophic cardiomyopathy, asymmetric septal hypertrophic subaortic stenosis caused by idiopathic hypertrophic called subaortic stenosis.A, Genetic: A family can have more than the disease, tips and heredity.
Second, endocrine disorders: the coexistence of tumor patients addicted to cheese hypertrophic cardiomyopathy were more likely, a large number of human intravenous infusion of norepinephrine can lead to myocardial necrosis. Animal experiments, intravenous infusion of catecholamines can lead to cardiac hypertrophy. Therefore suggested that hypertrophic cardiomyopathy is caused by endocrine disorders.The disease were significantly different between men and women, most symptoms in the 30-40 years old, with age, more obvious symptoms, the main symptoms are dyspnea, exertional dyspnea, orthopnea was serious or paroxysmal nocturnal dyspnea . angina; often typical angina, after the onset of labor. Chest pain lasting longer, with use of nitroglycerin and may increase not only the void. syncope and dizziness; more in fatigue occurs. Decrease in blood pressure, occurred when the fast or too slow arrhythmia and may also cause syncope, and dizziness. palpitations; patients feel heart beating strongly, especially in left lateral position is more significant,


perhaps because of arrhythmia or cardiac function were changed.
The treatment of hypertrophic cardiomyopathy is mainly adhere to clear the pathogen, repair myocardial damage, lesions blocking progress, gradually increase the heart of the retraction. Hypertrophic cardiomyopathy is the core of advanced pathological deficiency and blood stasis, Poison Heart network, the overall adjustment of focusing and improve immune function, reduce and remove the virus, blocking the progress of the disease. In the course of clinical treatment of patients through coordination with "the heart back to the Yuan Kang family medicine" can be achieved against myocardial fibrosis, myocardial termination of further injury, thereby slowing the decline of myocardial cells, while the aly damaged heart muscle cells may play restore cardiac function, reduce the clinical burden of heart before and after the repair cardiac muscle, the heart so as to achieve the final objective of the hospitals to continue to reduce the hypertrophic cardiomyopathy patients for regular return visits to monitor treatment effects. If the treatment of hypertrophic cardiomyopathy reasonable, timely, and hypertrophic cardiomyopathy patients by taking my heart back to the hospital per capsule, the patient may be taking 3-5 courses of rehabilitation, hypertrophic cardiomyopathy patients with good prognosis.
Affiliated Hospital of Shaanxi Province Heart Center Medical Association : Wang Chuansheng Tel: 86-029-88638691 Fax: 86-029-88620992 E-mail: webmaster@sxxzb.com Postal Code: 710014 Other: 029-88620992 Address: Xi'an is still 109 Shaanxi Road Rehabilitation Hospital on the second floor care (cardiovascular)
Overof the names of diseases disease hypertrophic cardiomyopathy disease Pinyin f i h u x ng x n j b ng English hypertrophic cardiomyopathy disease abbreviation HCM department treatment of cardiovascular medicine, cardiothoracic surgery may be factors that cause disease: a genetic : A family can have more than the disease, tips and heredity. Second, endocrine disorders: the coexistence of tumor patients addicted to cheese hypertrophic cardiomyopathy were more likely, a large number of human intravenous infusion of norepinephrine can cause myocardial
Schematic diagram of physiological necrosis. Animal experiments, intravenous infusion of catecholamines can lead to cardiac hypertrophy. Therefore suggested that hypertrophic cardiomyopathy is caused by endocrine disorders. Disease symptoms of the disease were significantly different between men and women, most symptoms in the 30-40 years old, with age, more obvious symptoms, the main symptoms are dyspnea, exertional dyspnea, severe orthopnea or paroxysmal nocturnal was shortness of breath. angina; often typical angina, after the onset of labor. Chest pain lasting longer, with use of nitroglycerin and may increase not only the void. syncope and dizziness; more in fatigue occurs. Decrease in blood pressure, occurred when the fast or too slow arrhythmia and may also cause syncope, and dizziness. palpitations; patients feel heart beating strongly, especially in left lateral position is more significant, perhaps because of arrhythmia or cardiac function were changed. Disease, X-ray examination is normal or increased heart size, heart size and heart and left ventricular outflow tract pressure gradient between the proportional, the greater the pressure gradient, the greater the heart. Left ventricular hypertrophy based, not widened aorta, pulmonary artery segment no more prominent, mostly mild pulmonary congestion, common mitral valve calcification. ECG of the heart ischemia, repolarization abnormalities, ST-T changes in common, left ventricular hypertrophy and left bundle branch block also were more common, probably due to ventricular septal hypertrophy and the emergence of Q wave myocardial fibrosis, the disease often with various types of arrhythmia. Echocardiography is an important non-invasive diagnostic methods. There mainly abnormal thickening of the interventricular septum, interventricular septum diastolic thick 15mm. septal decreased range of motion, generally 5mm. septal thickness / left ventricular posterior wall thickness ratio of up to 1.5-2.5:1, is generally believed that the ratio 1.5:1 has diagnostic significance. left ventricular end systolic diameter smaller than normal. start time systolic mitral valve compartment and the distance often significantly reduced. mitral systolic forward movement, close to the interventricular septum, before the end of the second heart sound. aorta mid off. Comprehensive analysis of more than 7 should be, can only draw the right conclusions, should be noted that hypertension, hypothyroidism, can cause a similar performance. Cardiac catheterization and angiocardiography cardiac catheterization, left ventricular and left ventricular outflow tract pressure gradient between the left ventricular end-diastolic pressure increased, the pressure and left ventricular outflow tract obstruction gradient was positively correlated. Angiocardiography, ventricular septal muscle hypertrophy is significant, visible ventricular cavity was narrow crack-like changes in the diagnosis of sense. Treatment of hypertrophic cardiomyopathy develops slowly, the prognosis is good, but because of arrhythmia can cause sudden death, life should be taken to avoid fatigue, to prevent excessive stress, blockers, experience encore reduce myocardial contractility, reduce the left ventricular wall of the left ventricular outflow tract obstruction improved compliance and left ventricular filling, but also has anti-arrhythmic effect. Dose: 10mg orally, 3 times a day. Can be gradually increased up to 480mg / day. Can also be used calcium channel blockers, verapamil 40mg orally 3 times a day, nifedipine 10mg, oral, 3 times a day. Can improve diastolic function, blood pressure should be observed to prevent the blood drop too low. Surgical treatment: pressure grad 60mmHg, ineffective drug therapy may be surgery. Possible resection of hypertrophic muscle. Those with severe mitral regurgitation, mitral valve replacement can do. Recently from the Institute of Basic Medicine, Hebei Medical University, Biochemical Research Center was informed that the room in the teacher Wenjin Kun, MD, Zheng Bin, Han Mei under the guidance of two professors, from the molecular, cellular and system-on reveals the overall level of protein induced cardiac hypertrophy hhlim transcriptional regulatory mechanisms, and found that antisense expression of nucleic acid technology can effectively reduce blocking hhlim cardiac hypertrophy and development. 1 At present the pathogenesis of cardiac hypertrophy remain unclear. Zheng Bindeng people over the past decade on human fetal heart cDNA library was screened to clone the new genes hhlim
ECG basic expression regulation, and the relationship between cardiac hypertrophy and how to reduce the incidence of cardiac hypertrophy and development of in-depth exploration. Task Force confirmed that the protein in muscle cells of different phenotype has two distinct cellular localization and function in undifferentiated muscle cells, hhlim localized in the nucleus, activated as a transcription factor genes of cardiac hypertrophy and BNP actin protein expression, induce cell hypertrophy. The whole animal experiments found that exercise and the formation of hypertensive cardiac hypertrophy and hhlim are closely related to high expression. Also found that blocking the use of antisense technology hhlim expression, which can effectively reduce the incidence of cardiac hypertrophy and development of effective disease prevention and control so as to provide an important experimental basis. Has long been considered that the cause of hypertrophic cardiomyopathy and genetic, are autosomal dominant. Clinically significant genetic family history of only about 30-55%, 40-50%, but no other genetic family history. This part of the patient may have that are subclinical, as can be confirmed by genetic analysis. In recent years, research on genetic aspects are: Some people reported that patients with hypertrophic cardiomyopathy causative gene in the long arm of chromosome 14, and cardiac myosin heavy chain genes are closely linked. There are also reports of hypertrophic cardiomyopathy causative gene in 1, 11 and 15 accounted for 30% of abnormalities. Another academic study in hypertrophic cardiomyopathy of different races were cardiac myosin heavy chain gene in a variety of missense mutations. Some scholars have reported that hypertrophic cardiomyopathy, 15 kinds of myosin heavy chain gene missense mutations are located in its head with the rod of the junction. In short molecular level through the study of cardiac hypertrophy in addition certain gene mutation, there are angiotensin receptor, the calcium changes within the environmental impact Deng Jun, needs further study. Type apical hypertrophic cardiomyopathy information from abroad, it seems, hypertrophic cardiomyopathy, the main non-symmetry in the West mainly ventricular septal hypertrophy, University of Minnesota Medical School reported that a group of patients: asymmetric septal hypertrophy involving the nipple 90% the level of 2% of the muscle and left ventricular apical wall hypertrophy after 3% 5% septal hypertrophy, but even the Japanese data center in hypertrophic cardiomyopathy hypertrophy accounted for 26.5-50% tip. In Europe, less apical hypertrophy, hypertrophic cardiomyopathy accounted for about 2-4%. Rarely reported in China in the past, and gradually increased in recent years have been found. I have been diagnosed in recent years, there are dozens of such cases of heart disease as much as that in the East race is common in such cardiomyopathy. Age of onset of the disease can be 15-80 years old to 30-60 years of age were more common among, the few clinical symptoms, in patients with advanced can have chest pain, palpitations, respiratory flow, dizziness, fatigue and so on. ECG chest lead T wave is often low and flat, and some, such as coronary T wave T wave also like to V3, V4, V5, V6 leads the most obvious. ST segment depression and some can also be 3-4mm, but also more significantly associated in mind leading, labor, is often diagnosed as coronary heart disease, or even subendocardial myocardial infarction, but there is no clinical risk factors for coronary heart disease. There ECG left ventricular high voltage, some patients have Q-T interval prolongation, can occur mitral P wave. In late may have a variety of arrhythmias. In addition some patients had ST segment and T wave dynamics, good times and bad. Echocardiography diagnosis of the disease have special value, when the normal cardiac apex in diastolic thickness of 9.4 3.1mm, and in apical hypertrophic cardiomyopathy, the apical thickening thickness to 14-35mm, an average of 24 -25mm. Yamaquchi reported apical hypertrophic cardiomyopathy, the apical hypertrophy was 24.8 6.6mm, but echocardiography can sometimes missed, one in early, even in the electrocardiogram T wave changes have occurred when the echocardiography report "normal", the other does not check for multiple planes, so there are suspicious clinical cases should be long on detailed observation plane, you can increase the positive rate. Also in some patients systolic anterior mitral leaflet may have prior to the exercise, or left ventricular end diastolic pressure and compliance, except for a few outside the most no pressure gradient. In recent years, there are clinical MRI, radionuclide myocardial scan in the diagnosis of great help, and heart cavity imaging, clinical cardiac biopsy and other methods have been less. Apical hypertrophic cardiomyopathy without obstruction of blood flow because of early symptoms of 10-20 years or less and a good prognosis. Webb reported 26 cases in 1996 were followed up for 1-22 years, average 7.3 years, no sudden death cases, but can occur in patients with advanced chest pain, breathing not ring true, or arrhythmias, sudden death may also occur, can be combined with advanced heart expansion, the occurrence of heart failure. If the onset of middle age, another risk factor for coronary heart disease, can also associated with coronary heart disease. Most of such cases I have to coronary angiography, two patients with coronary artery disease undergoing coronary artery bypass surgery. Hypertrophic cardiomyopathy with hypertension more than hypertension incidence in middle age, such as long-term treatment may also cause not fully ventricular hypertrophy and left ventricular hypertrophy, but the majority only in the interventricular septum thickness of about 1.3cm, than the degree of ventricular hypertrophy in hypertrophic significant heart disease, such as the existence of the ventricular wall while the two septal hypertrophy and more pronounced. Of course, should be understood in the history, hypertension, cardiac hypertrophy in line before or after, the other needs to understand the course of hypertension, severity, whether there is treatment, the treatment effects. For the treatment of hypertrophic cardiomyopathy progress 1, medical therapy: long-standing hypertrophic cardiomyopathy is the application of the main drug treatment (1) Calcium blockers: application of long-acting release formulation such as verapamil, diltiazem long-term treatment, can make in remission, or slow down progress. Abroad reported that a group of patients treated continuously for 14 years is still valid. (2) blockers. (3) Belladonna bases: One micro-adjustment (ie Kelang Ning, coronary Soviet Union) also have a certain effect long-term use. But when glaucoma or prostatic hypertrophy not serious, I have to use this drug more than ten years, or with calcium blockers, or alternately, a good effect. To have frequent ventricular arrhythmias amiodarone can also be used to take, or sequestration DDD pacemakers have good effect. 2, surgical treatment: (1) If the obstruction, intracardiac pressure grad 30mmHg, may be considered for resection of ventricular cardiac hypertrophy, efficacy, and abroad, only 2-3% mortality rate reported. (2) If the second was closed, but also the artificial valve replacement. (3) If sufficient s of donor hearts, the disease can also be carried out in patients with advanced heart transplants. Medication attention to be used with caution in patients with hypertrophic cardiomyopathy decreased cardiac preload and afterload of the drug should not increase the intraventricular obstruction. Digitalis to enhance myocardial contractility, left ventricular outflow tract obstruction may also add to further reduce cardiac output, hence caution. Patients with angina merger, due to left ventricular outflow tract obstruction nitroglycerin can increase, it is disabled. Hypertrophic cardiomyopathy is characterized by cardiac hypertrophy. According to whether the left ventricular outflow tract obstruction can be divided into obstructive and non-obstructive hypertrophic cardiomyopathy, asymmetric septal hypertrophic subaortic stenosis caused by idiopathic hypertrophic called subaortic stenosis. For caution in patients with hypertrophic cardiomyopathy decreased cardiac preload and afterload of the drug should not increase the intraventricular obstruction. Digitalis to enhance myocardial contractility, left ventricular outflow tract obstruction may also add to further reduce cardiac output, hence caution. Patients with angina merger, due to left ventricular outflow tract obstruction nitroglycerin can increase, it is disabled. Blockers and calcium channel blockers reduce ventricular obstruction, relieve symptoms, often a certain effect. Application of verapamil the first few weeks of treatment about 20% of the patients and the first class side effects of nausea, Zhu Huanzhe not be easily discontinued, the symptoms continued to gradually disappear after use. Drug should start small, increase the amount should not be too fast to observe the adverse reactions in nursing, such as arrhythmias and orthostatic hypotension, inform your doctor immediately if found to be addressed. Treatment of hypertrophic cardiomyopathy: hypertrophic DECOCTION synthesis from 23 herbs, the following brief details for you, want to help you. Radix, the system one and, Schisandra, fried citrus aurantium, the system Mou large littoralis, Poria, Chuanxiong, a bead, red peony, loofah, wheat, Zao Ren, Bo Ziren, Wulingzhi, Panax, Puhuang, saffron, leech, gall stars, Polygalaceae, amber, cinnabar. Shu Chu Chang Fang a meridian, through the orifices of customs; Panax stasis to stop bleeding, reduce swelling and pain; Leech
Poxue hypertrophic cardiomyopathy, stasis, pass through; over the shamisen Fang, Chinese-based medicine; Ophiopogon YangYinShengJin, lungs and a pure heart; system one and mitogenic effect; Schisandra convergence Guse, Qi Sheng Jin, Kidney Ningxin; fried citrus aurantium phlegm San ruffian, broken gas consumer product; system Mou Tai promoting blood circulation, blood stasis and relieve pain; littoralis Yangyinqingfei, stomach fluid; more Chinese-based party chen Liu Wei drug; Poria and Water Shenshi, spleen rather heart; Chuanxiong blood circulation of qi, dispelling wind pain, for the calm nerves; TPG Qingreliangxue, Sanyu pain; loofah through the meridians, detoxification swelling; wheat support Anshen, in addition to trouble; Zaoren nourishing the heart, nerves, sweat convergence; Bozi Ren Yang Xin sedative, laxative; Wulingzhi blood stasis; Puhuang bleeding, blood, Tonglin; saffron and blood circulation, removing blood stasis, pain; bile Star Qinghuo phlegm, Anticonvulsant be obstinate disease; Polygala tranquilizer puzzle, expectorant, swelling; over twelve herb-based side adjuvant; amber sedative, diuretic, blood; cinnabar city, pure heart, soothe the nerves; above two herbs as The side to medicine.


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