Pediatric Hypertrophic Cardiomyopathy Differential Diagnoses
- Author: Christina Y Miyake, MD; more...
Diagnostic Considerations
Children with hypertrophic cardiomyopathy (HCM) may not be symptomatic. Careful evaluation of a heart murmur may reveal HCM.
Early diagnosis of HCM is of prime importance if sudden cardiac death is to be prevented by prescription of an appropriate level of safe activity, medications, surgery, or an implantable cardioverter defibrillator. Because this is an autosomal dominantly inherited disease, screening of first-degree relatives with physical examination, electrocardiography (ECG), and echocardiography is useful to identify additional family members with HCM before the onset of significant symptoms or sudden death.
Syncope identifies children with HCM who are at significantly increased risk of sudden death and warrants an urgent evaluation. Like syncope, presyncope warrants a directed evaluation to rule out malignant arrhythmias. A thorough investigation is warranted to rule out potential malignant etiology of presyncopal symptoms.
Differential Diagnoses
- Aortic Stenosis, Subaortic
- Cardiomyopathy, Restrictive
- Fabry Disease
- Glycogen-Storage Disease Type I
- Glycogen-Storage Disease Type II
- Infant of Diabetic Mother
- Neonatal Hypertension
- Ventricular Fibrillation
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