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Hypertrophic cardiomyopathy
Miocardiopatía hipertrófica
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Juan José Santos Mateoa, María Sabater Molinab,c, Juan Ramón Gimeno Blanesa,c,
Corresponding author
jgimeno@secardiologia.es

Corresponding author.
a Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
b Laboratorio de Cardiogenética, Instituto Murciano de Investigación Biosanitaria, Murcia, Spain
c Universidad de Murcia, Murcia, Spain
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Received 31 July 2017. Accepted 05 September 2017
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Table 1. Causes of ventricular hypertrophy in paediatric and adult age, and main differential characteristics.
Abstract

Hypertrophic cardiomyopathy is the most common inherited cardiovascular disease. It is characterized by increased ventricular wall thickness and is highly complex due to its heterogeneous clinical presentation, several phenotypes, large number of associated causal mutations and broad spectrum of complications. It is caused by mutations in sarcomeric proteins, which are identified in up to 60% of cases of the disease.

Clinical manifestations of hypertrophic cardiomyopathy include shortness of breath, chest pain, palpitations and syncope, which are related to the onset of diastolic dysfunction, left ventricular outflow tract obstruction, ischemia, atrial fibrillation and abnormal vascular responses. It is associated with an increased risk of sudden cardiac death, heart failure and thromboembolic events. In this article, we discuss the diagnostic and therapeutic aspects of this disease.

Keywords:
Hypertrophic cardiomyopathy
Genetic diagnosis
Sarcomeric mutations
Therapy
Sudden cardiac death
Resumen

La miocardiopatía hipertrófica es la enfermedad hereditaria cardiovascular más frecuente. Se caracteriza por un aumento del grosor de las paredes ventriculares y se trata de una entidad con un manejo clínico complejo como lo demuestra la gran heterogeneidad en su presentación clínica, las diferentes manifestaciones fenotípicas, el gran número de mutaciones causales y el amplio espectro de complicaciones asociadas. Es causada por mutaciones en las proteínas sarcoméricas, pudiendo identificarse hasta en un 60% de los casos la mutación patogénica.

Las manifestaciones clínicas de la enfermedad son disnea, dolor torácico, palpitaciones y síncope, y están relacionadas con la aparición de disfunción diastólica, obstrucción al tracto de salida del ventrículo izquierdo, isquemia, fibrilación auricular y respuesta vascular inadecuada. Conlleva un aumento del riesgo de muerte súbita, de insuficiencia cardiaca y de eventos tromboembólicos. En el presente artículo, se revisan los aspectos diagnósticos y terapéuticos de la enfermedad.

Palabras clave:
Miocardiopatía hipertrófica
Diagnóstico genético
Mutaciones sarcoméricas
Tratamiento
Muerte súbita cardiaca

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