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Hypertrophic cardiomyopathy (hypertrophic cardoiomyopathy) is characterized by asymmetrical septal hypertrophy, abnormal myocardial cell hypertrophy, and systolic mitral valve orientation disorders such as sails to move forward. Hypertrophy of the muscle wall compliance decreased, resulting in increased resistance to ventricular filling. Clinical manifestations of varying degrees of ventricular filling rather than emptying delay is limited. According to the phenomenon of left ventricular outflow tract obstruction with or without obstruction can be divided into two types of non-obstructive. Or two right ventricular outflow tract ventricular outflow tract obstruction who are rare. Often leads to sudden death, infective endocarditis can be complicated.Eye of both sides of the ventricular hypertrophy significantly, heart weight increased, the average heart weight for the normal 1 to 2 times (with an average adult heart weight 582g, a few up to 1000g). Most cases of septal thickness greater than the left ventricular free wall (Figure 8-34, Figure 8-35), hypertrophy can be limitations, can affect the heart at the base (under the aortic valve), ventricular septal, or apical area in central . Move forward with the septal mitral valve systolic results of the s can lead to mitral valve thickening and subaortic endocardial fibrosis. Before the occurrence of heart failure, left ventricular generally not expansion.
Electron microscopy, mainly for the side adjacent cells appear intercalated disc connections between cells; from the bottom of a myofibrillar Z band filaments can be inserted into another different angle of the Z band of myofibrils to form a woven-like arrangement. Sometimes can be seen from the broadening of the Z filaments with radiation in all directions. However, the contralateral side of muscle cells and muscle fiber connection arrangement disorder hypertrophic cardiomyopathy is not unique to the changes.Figure 8-34 hypertrophic cardiomyopathy
Heart cross-section of the icon (top , asymmetric ventricular septal hypertrophy (taken from Becker and Anderson)Figure 8-35 hypertrophic cardiomyopathy
Ventricular cross-sectional (top , left ventricular cavity narrow, uniform thickening of the heart wall, the myocardial fibrosis area covered with white, ventricular septal and posterior wall thickness ratio is only slightly larger than normal (1.4)Microscopically, cardiac muscle cell hypertrophy significantly, large and strong nuclear staining (Figure 8-36), nuclear Zhou Youliang area surrounded by staining proved to be glycogen accumulation, with a certain diagnosis. Disordered arrangement of myocardial cells than other cardiomyopathy staggering, and often has spiral-shaped or winding was arranged in clusters (Figure 8-37), cells without myofibrils arranged in parallel, but in all directions, each staggered. Interstitial fibrosis are often foci formation, but to intimal fibrosis, especially in the area under the aortic intimal fibrosis is prominent. Hypertrophy of the interventricular septum in the coronary artery wall thickening often.Figure 8-36 hypertrophic cardiomyopathy
Cardiac hypertrophy, and a large stain 360 (taken from Edwards)Figure 8-37 hypertrophic cardiomyopathy
Disordered arrangement of myocardial cells 180 (original magnification) (taken from Edwards)Electron microscopy, mainly for the side adjacent cells appear intercalated disc connections between cells; from the bottom of a myofibrillar Z band filaments can be inserted into another different angle of the Z band of myofibrils to form a woven-like arrangement. Sometimes can be seen from the broadening of the Z filaments with radiation in all directions. However, the contralateral side of muscle cells and muscle fiber connection arrangement disorder hypertrophic cardiomyopathy is not unique to the changes.


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