Pediatric Hypertrophic Cardiomyopathy Differential Diagnoses

  • Author: Christina Y Miyake, MD; Chief Editor: P Syamasundar Rao, MD  more...
 
Updated: Jan 04, 2016
 
 

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.[9]

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

 
 
Contributor Information and Disclosures
Author

Christina Y Miyake, MD Assistant Professor of Pediatric Cardiology, Texas Children's Hospital

Christina Y Miyake, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, Massachusetts Medical Society, Pediatric and Congenital Electrophysiology Society

Disclosure: Nothing to disclose.

Coauthor(s)

Charles I Berul, MD Professor of Pediatrics and Integrative Systems Biology, George Washington University School of Medicine; Chief, Division of Cardiology, Children's National Medical Center

Charles I Berul, MD is a member of the following medical societies: American Academy of Pediatrics, Heart Rhythm Society, Cardiac Electrophysiology Society, Pediatric and Congenital Electrophysiology Society, American College of Cardiology, American Heart Association, Society for Pediatric Research

Disclosure: Received grant/research funds from Medtronic for consulting.

Chief Editor

P Syamasundar Rao, MD Professor of Pediatrics and Medicine, Division of Cardiology, Emeritus Chief of Pediatric Cardiology, University of Texas Medical School at Houston and Children's Memorial Hermann Hospital

P Syamasundar Rao, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, American College of Cardiology, American Heart Association, Society for Cardiovascular Angiography and Interventions, Society for Pediatric Research

Disclosure: Nothing to disclose.

Acknowledgements

Christopher Johnsrude, MD, MS Chief, Division of Pediatric Cardiology, University of Louisville School of Medicine; Director, Congenital Heart Center, Kosair Children's Hospital

Christopher Johnsrude, MD, MS is a member of the following medical societies: American Academy of Pediatrics and American College of Cardiology

Disclosure: St Jude Medical Honoraria Speaking and teaching

Ameeta Martin, MD Clinical Associate Professor, Department of Pediatric Cardiology, University of Nebraska College of Medicine

Ameeta Martin, MD is a member of the following medical societies: American College of Cardiology

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
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Hypertrophic cardiomyopathy. Image courtesy of Michael E. Zevitz, MD
Sarcomeric genes involved in hypertrophic cardiomyopathy (adapted from Priori 1999).
ECG of a 16-year-old with hypertrophic cardiomyopathy (HCM), demonstrating left ventricular hypertrophy pattern and "pseudo-preexcitation."
 
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