Hypertrophic Cardiomyopathy

Cardiovascular · ~11% of blueprint

Pathophysiology: Autosomal-dominant sarcomere mutation → asymmetric septal hypertrophy → LV outflow obstruction (HOCM) + diastolic dysfunction.
Signs & Symptoms: Dyspnea, angina, syncope; harsh systolic murmur that ↑ with ↓preload (Valsalva, standing). May present as sudden cardiac death in a young athlete.
Gold Standard Diagnosis: Echocardiography (septal hypertrophy, systolic anterior motion of mitral valve, outflow gradient). ECG: LVH, deep septal Q waves.
First-line Treatment: Beta-blocker (or non-DHP CCB); avoid dehydration, vasodilators, and diuretics. Septal myectomy/ablation if refractory; ICD if high SCD risk.

High-Yield Pearl

Murmur ↑ with Valsalva/standing (↓preload) — opposite of most murmurs. Leading cause of sudden death in young athletes; screen first-degree relatives.

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