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lvh vs hcm

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  • lvh vs hcm

    after reading previous posts, im somewhat confused. it has been stated that left venticular hypertrophy (lvh) is NOT the same as hcm, and is in fact reversible. the difference is that the cells of a hcm patient are in a different pattern from normal heart cells and this is how you can distinguish between the two. it was also said that lvh is probably due to untreated hypertension whereas hcm is generally thought to be genetic.

    if all this is all correct, how does one know which one they have without some type of biopsy of the heart muscle? also is it possible that some people have had myectomys unneccessarily as they only had lvh which with excercise and diet may have been reversible? being a patient myself and also having been to mayo and considering surgery, no one has ever discussed the two similiar types of diseases and their implications.

  • #2
    You're asking hard questions that I don't know the answer to. I hope that one of our nurses or Lisa will pop in and help. I think part of the answer lies in the assymetry of HCM, but I'm not sure.

    Reenie
    Reenie

    ****************
    Husband has HCM.
    3 kids - ages 23, 21, & 19. All presently clear of HCM.

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    • #3
      Hello Rich,
      Welcome to the message board! You might try to do a search on previous posts regarding LVH. I'm sure this has been discussed in the past. In my experience over the past several years I have organized 10 heart screening events, and provided over 1700 FREE echo-cardiograms in communities across the country. This same question has been brought up during my heart screening events. According to the cardiologists that I have talked to "concentric hypo-trophy" which is equal enlargements around all the heart chambers, could be caused by hypertension.

      But, I was recently at a symposium that had some different views regarding any enlargements of the heart. I'm not sure I agree, so we will leave it for the experts to arm wrestle.

      So, it would be in your best interest to discuss this question with Lisa. She is our "know all" expert that we refer a lot of the hard questions to.

      Stay informed! Best of luck!
      Sharon Bates

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      • #4
        I know many times if the doctor suspects LVH or "athlete's heart" they will have the person decondition for a period of time I believe 6 months to a year and see if the ventricle reduces. The myectomy is typically used only for the septal enlargement. There are very few myectomies done on concentric or Apical because they are complicated to do. As far as hypertension goes I know many of us with HCM have normal or lower blood pressures not all and that is not a scientific fact I've found.

        As far as a biopsy goes the doctor would have to hit a part of the heart where the disarrayed cells are. The entire heart cells are not disarrayed and since the treatment I believe is typically the same it is not worth the risk of a biopsy.

        Just my two cents!

        Mary S.

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        • #5
          Hi Rich,

          LVH is indeed usually from uncontrolled /untreated Hypertension. It may also be influenced by some other entities as well. From what I was told it would usually result from about 20 years or more of high BP and no medication that effectively reduced it. I quess the doctor who treated that patient would be grossly negligent or did that person live on a remote Island!! It is often more prevalent in elderly women and therefore often presents when they are in their early seventies. This is the most common way in which it presents.

          Now as far as myectomy's being done on people who do not need them. I assure you that a very thorough testing is done by the specialists and very thorough history taking is very pertenent to an accurate diagnosis. Of course once an individual has had a myectomy the pathology is done and it is determined and confirmed as whether it was indeed HCM; the genetic disease. I have heard of no cases in which a myectomy was done on someone who did not actually have HCM. I am sure Lisa will jump in and alert us if this has otherwise been an issue.

          FYI: I was told I had LVH by my doctor when the @#&*!!$*& started hitting the fan,( my BP in fact was very controlled from the start on meds), I became my own personal medical investigator to get to the bottom of his bogus labeling. Myectomy done 10-15-03 for asymetric hypertrophy( surgery is performed on the septum only which is causing the obstruction/ gradient to the outflow tract and usually causing systiolic anterior motion of the mitral valve leaflets which causes some varied mitral regurgitation The rest of the ventricle will continue to be hypertrophied.) Yup you got it , pathology on the specimen removed from my heart = HCM.

          Stay tuned for others input here.

          Pam
          Dx @ 47 with HOCM & HF:11/00
          Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
          Lead failure,replaced 12/06.
          SF lead recall:07,extracted leads and new device 2012
          [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
          Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
          Genetic mutation 4/09, mother(d), brother, son, gene+
          Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

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          • #6
            As for me personally, I know that I have HOCM.

            My brother died of sudden cardiac death at the age of 34, they did an autopsy on him and a pathology report on his heart and it said Hypertrophic Obstuctive Cardiomyopathy.

            In my case it is for sure HOCM.
            49 yrs. old
            Diagnosed at 31.
            Cardiac Arrest 2003, RF Ablation in AZ, no positive result -
            First ICD 2003 - In 2006 lead went bad, abandoned lead, threaded new one & new generator
            Myectomy 5-5-05 at The Cleveland Clinic - Dr. Lever & Dr. Smedira -heart surgeon.
            Currently have Grade 2 Diastolic Dysfunction with pulmonary hypertension & pulmonary edema.
            My brother passed away suddenly at 34 yrs old from HCM.
            2 teenage children, ages 17 and 15.

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