Cardiac hypertrophy and hypertrophic cardiomyopathy: Introduction and management

The magnitude of hypertrophic response of the left ventricle to pressure overload is variable and likely is mediated by genetic factors as well as other identified mechanisms. Myocardial hypertrophy is a common phenotype of multiple cardiac disease entities. Left ventricular hypertrophy (LVH) causes significant morbidity and mortality in adults. Increased pressure overload is a key stimulus for the development of LVH in hypertensive patients as well as in those with aortic valve stenosis through several molecular mechanisms. Hypertrophic cardiomyopathy (HCM) is present in 1 in 500 people in the general population and is the most common genetically transmitted cardiomyopathy. HCM can be caused by more than 1,400 different mutations and is transmitted in an autosomal dominant pattern. Many individuals affected by HCM are undiagnosed, and most do not experience lethal events or symptoms. However, those who develop symptoms such as dyspnea, angina, and lightheadedness can experience functional disability secondary to heart failure and stroke as well as to sudden cardiac death (SCD). The majority of HCM patients are treated medically with the initial aim of reduction of symptoms along with reducing the risk for SCD. Therapy of patients with HCM can be classified into medical, interventional/device, and surgical treatments.