HOCM and Atrial Masses

Thank you Harry, Prashant, and Swalpa for sharing 3 amazing echocardiograms in report today! We discussed echo findings and pathophysiology of mitral valve endocarditis, hypertrophic cardiomyopathy, and atrial masses!

Top Pearls from Today:

  • YY’s pearl: Mitral valve leaflets tend to be more mobile than those of other valves in the heart, and carry a higher risk of embolic phenomenon in the setting of endocarditis.
  • Harry’s pearl: Staph Aureus not only causes endocarditis, but also can extend into the myocardium, causing myocarditis!

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For those of you craving more… HOCM and Atrial Masses!

HOCM

  • Remember that histopathology in patients with HOCM show myocardial disarray – hypertrophied myocytes arranged in a chaotic and disorganized fashion

hocm

  • Clinical manifestations: many patients are asymptomatic, but others can develop one or more symptoms of DOE, fatigue, angina, syncope, palpitations, or acute hemodynamic collapse : Both supraventricular arrhythmias (primarily atrial fibrillation) and ventricular arrhythmias occur
  • Echo findings of HOCM:  LV hypertrophy, systolic anterior motion of the mitral valve (SAM), left ventricular outlet tract (LVOT) obstruction
  • Counseling of Families: HOCM is an autosomal dominant disorder, with a high degree of penetrance : first-degree family members of affected patient should be evaluated for possible inheritance. : Evaluation includes history, examination, ECG, and echocardiogram : Routine genetic screening of first-degree relatives is not recommended unless a definite HOCM-causing mutation has been identified in the index patient.

Atrial Masses

Flashback to our prior pearls on atrial masses!

https://ucsfmed.wordpress.com/2016/08/03/moffitt-am-report-pearls-8316-atrial-masses-and-platypnea-orthodeoxia-syndrome/

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