Talk:Hypertrophic cardiomyopathy

Alcohol septal ablation
Actually the septal that is infused with alcohol may not be the first septal perforator. What is done in experienced centers is an echocardiogram (I'm not sure if it is a TTE or TEE) at the time of the angiogram. The septal artery is occluded with a balloon and echo contrast (or agitated saline?) is injected distally into the septal perforator. The wall motion is then observed via echo to see if the gradient improves and also to see what portion of the septum will be affected by the ablation. Will have to find a reference or two to add this to the article. Ksheka 14:13, 30 November 2006 (UTC)

Historical information?
Who first identified hypertrophic cardiomyopathy as a disease? —Temporaluser 07:22, 19 March 2008
 * Belated thanks for the question. Now Donald Teare's landmark 1958 paper is highlighted in the article. —Patrug (talk) 10:34, 6 February 2017 (UTC)

hi, can anyone tell me what age is the oldest person live till with hcm please — Preceding unsigned comment added by 86.17.231.204 (talk) 10:44, 13 October 2016 (UTC)
 * It's doubtful that anyone has a reliable record for this. For some reassurance, the first paragraph of the article now summarizes: "In most patients, HCM is associated with little or no disability and normal life expectancy." —Patrug (talk) 10:34, 6 February 2017 (UTC)

Etymology?
Should there not be an etymology for medical terms? At least people are made aware of the origin of the medical terms and what they mean. For example Hypertrophic from the Greek hyper + trophy and cardiomyopathy from the Greek kardia + mus + pathy.....1.120.132.240 (talk) —Preceding undated comment added 07:26, 13 September 2013 (UTC)
 * Thanks. The first sentence of the article now summarizes: "Hypertrophic cardiomyopathy (HCM) is a disease in which a portion of the myocardium (heart muscle) is hypertrophic (enlarged) without any obvious cause, creating functional impairment of the heart." —Patrug (talk) 19:28, 6 February 2017 (UTC)

Lancet journal reference links
10.1016/S0140-6736(16)31321-6

—JFW &#124; T@lk  09:32, 2 December 2016 (UTC)

10.1016/S0140-6736(12)60397-3

—Patrug (talk) 04:55, 30 December 2016 (UTC)

HCM sine obstructio
10.1016/j.amjmed.2016.09.015 not all HCM causes septic hypertrophy. A proportion progresses to CCF. JFW &#124; T@lk  21:13, 22 January 2017 (UTC)

Notable cases
An editor has deleted the entire list of notable cases, which has been part of this article for years. The editor has pointed to WP:MEDTRIVIA, but that says that lists of cases may be maintained (or split to a separate list) as long as they are well-sourced, which this list has been, for the most part. I've raised the issue at Wikipedia talk:Manual of Style/Medicine-related articles--Arxiloxos (talk) 18:16, 23 January 2017 (UTC)


 * here is the list as it was, so we can discuss it


 * Notable cases

British comedy actor Leonard Rossiter died from hypertrophic cardiomyopathy in 1984 while waiting to go onstage at the Lyric Theatre, London.

After the death of Marc-Vivien Foé of Cameroon during a 2003 FIFA Confederations Cup match, his autopsy revealed hypertrophic cardiomyopathy. Miklós "Miki" Fehér, a Hungarian football player who died during a match on January 25, 2004, also suffered from HCM.

The autopsy of actor Corey Haim identified HCM as one of the contributing causes (along with pneumonia and coronary arteriosclerosis) for his death in 2010.

Internet personality Ben Breedlove of Austin, Texas died on December 25, 2011, from HCM at age 18.

Andrew Breitbart, a prominent American conservative journalist, died from hypertrophic cardiomyopathy on February 29, 2012, at age 43.

English footballer Mitchell Cole died from HCM on December 1, 2012, after retiring earlier in the year due to the condition.

Other noted athletes believed or suspected to have died from HCM include NFL players Thomas Herrion, Mitch Frerotte, Gaines Adams, and Derrick Faison; NBA players Reggie Lewis,   Jason Collier,  and Kevin Duckworth;  NHL player Sergei Zholtok; long-distance runner Ryan Shay;  Loyola Marymount basketball star Hank Gathers;  Loyola Marymount soccer player David Kucera; Western Kentucky University basketball player Danny Rumph; Kansas State football player Anthony Bates; LSU baseball player Wally Pontiff Jr.; Russian ice hockey star Alexei Cherepanov; and American strongman Jesse Marunde.

The Ontario Hockey League's Mickey Renaud Captain's Trophy honors former Windsor Spitfires captain Mickey Renaud, who died of HCM at age 19.

On December 10, 2008, NBA player Cuttino Mobley announced his retirement due to HCM.

The disease also ended the career of former Wake Forest basketball star Robert O'Kelley, after a mandatory ECG in Brazil discovered his condition in 2006.

Current University of Denver assistant hockey coach David Carle was originally recruited to play for the team, but retired from playing after being diagnosed with HCM at the NHL draft combine. He was nonetheless drafted in the 7th round by the Tampa Bay Lightning.

Former Arsenal and Watford goalkeeper Manuel Almunia announced his retirement on August 26, 2014 after being diagnosed with HCM.

Caleb Logan Bratayley, a 13-year old YouTube star, died from undiagnosed hypertrophic cardiomyopathy on October 1, 2015.

-- Jytdog (talk) 01:27, 24 January 2017 (UTC)


 * and reviewing it... while it is mostly (not completely) sourced, this is WP:GOSSIP and WP:NOTCATALOG is relevant too. What MEDMOS says is that we rarely include these lists, and when we do, it is people who in some way advanced treatment or research into the condition.  See how Lou Gehrig is mentioned in the history of ALS Amyotrophic_lateral_sclerosis?  And likewise have a look at the relevant section in the Parkinson's article: Parkinson%27s_disease Jytdog (talk) 01:32, 24 January 2017 (UTC)


 * While a few of these entries might be questioned, and the text could be written differently, I strongly disagree with the characterization of this content as "gossip" or the "scandal mongering" that WP:GOSSIP talks about. Coverage of notable cases of people--especially the athletes--who have either dropped dead or who have had their careers ended are the main way that the general public encounters this disease.  (For example, see David Epstein's writing about this condition, e.g.,  and .)  And I note that I am not the only experienced editor who has recently expressed concern about the argument that this kind of information should be excluded.  But I guess we can put this content into a separate list article like the others in Category:Lists of people by medical condition, as specifically recommended by WP:MEDCASE. --Arxiloxos (talk) 05:11, 24 January 2017 (UTC)
 * It is normal in a biographical article to describe what someone died of; that does not mean the person's death or having a condition is noteworthy in the article about the condition. This is what MEDMOS talks about - it is only relevant to name someone in the condition article, if there are reliable sources describing how the person having it or dying from it is relevant to the condition.
 * Yes, putting these people into a separate list article is the way to go. Jytdog (talk) 05:19, 24 January 2017 (UTC)
 * MEDMOS says "Articles on medical conditions sometimes include lists of notable individuals", which is more permissive than "we rarely include these lists". Its reference to "rare" is about rare diseases, which almost always include these lists as part of the article rather than as a separate article.  This condition would probably be better described as "low prevalence" than actually "rare", but it's certainly not the kind of common condition that could spawn a mile-long list of famous patients.
 * I could go either way with this one, but I'm slightly inclined to leave it here. It's not unusually long (~350 words, compared to a total of ~5,100 words in the rest of the article, so about 6% of readable article content) and seems to be adequately sourced.  However, if it's kept here, then I think that the "believed or suspected" paragraph should probably be removed, and only the "confirmed in news sources" examples kept.  WhatamIdoing (talk) 07:44, 24 January 2017 (UTC)
 * Given half an hour I could probably find hundreds of people to add to such a list, there are typically a few cases mentioned in the news every year. The risk when creating a list is also that it becomes an arbitrary collection - hence trivia. Carl Fredrik   💌 📧 09:52, 24 January 2017 (UTC)
 * I am not a big fan of these lists generally. IMO for anyone to be included they 1) need to be significantly notable (such that they have a non paid for Wikipedia article) 2) there needs to be significant coverage of them with the disease (not simple a tweet or a FB post, or a mention in passing when talking about something else) Doc James  (talk · contribs · email) 04:48, 25 January 2017 (UTC)
 * Carl, in my experience, if you want to keep the list short, then it needs to stay in the main article. It's easier to put a limit on a list when it's in the main article.  You can meet every addition with a discussion about whether including this one is important enough to justify removing another one.  OTOH, if the whole purpose of the page is to list people with the condition, then it probably will end up being the size of the List of people with breast cancer.  WhatamIdoing (talk) 08:32, 25 January 2017 (UTC)
 * I'm not so interested in keeping the list short as just entirely nonexistant. If someone where to create a list of people with hypertrophic cardiomyopathy, let them. But it does not belong in the main article at all. Carl Fredrik   💌 📧 14:45, 28 January 2017 (UTC)

Cases per year?
I'd be more inclined to keep the list of people in there if there were only 10 cases per year, such that people suffering from it are rare. But as the intro states, 0.2% incidence per year, thats a lot of people being diagnosed per year. Actually, that languange could be expanded (xx cases per 100,000 per year is a format I think I've encountered), and could be useful viz this discussion. BakerStMD 16:00, 24 January 2017 (UTC)


 * The lead section says 0.2–0.5% is HCM's overall prevalence in the population (not per year). The Prognosis section says the annual mortality from HCM is about 1% of patients. So, based on those numbers, expect 2 to 5 HCM deaths per 100,000 population per year, comparable to the rate of traffic deaths in safer countries like the UK. This means 20 to 50 annual HCM deaths among the ~1,000,000 living people with articles on English Wikipedia, which is probably too many to track. Doing it properly would mean adding another name every week or two, forever.
 * If we only track the young athletes for whom HCM is most widely known, we can improve the existing list in the linked article Sudden death of athletes. —Patrug (talk) 15:07, 28 January 2017 (UTC)
 * I just updated that linked list, now at Sudden cardiac death of athletes. Further suggestions welcome. —Patrug (talk) 06:21, 5 February 2017 (UTC)

unsourced
The following is unsourced or almost entirely unsourced. Moved here per WP:PRESERVE. Per WP:BURDEN, don't restore without finding MEDRS sources, checking the content against them, and citing them.

Individuals with HCM have some degree of left ventricular hypertrophy. Usually this is an asymmetric hypertrophy, involving the inter-ventricular septum, and is known as asymmetric septal hypertrophy. This is in contrast to the concentric hypertrophy seen in aortic stenosis or hypertension. About two-thirds of individuals with HCM have asymmetric septal hypertrophy.
 * Pathophysiology

About 25% of individuals with HCM demonstrate an obstruction to the outflow of blood from the left ventricle during rest. In about 70% of patients, however, the obstruction can be provoked under certain conditions. This is known as dynamic outflow obstruction because the degree of obstruction is variable and is dependent on the loading conditions (ventricular filling and arterial blood pressure) and the contractility state of the left ventricle.

Myocardial hypertrophy and extracellular fibrosis predispose to increased left ventricular stiffness, which in concert with compromised cellular energetics and abnormal calcium handling, leads to diastolic dysfunction manifested as dyspnea and exercise intolerance.

The altered structure of the coronary vessels and increased diastolic pressure (reduced blood supply), together with the hypertrophy and the outflow tract obstruction (increased demand), cause myocardial ischemia that is manifested as angina and may be responsible for the triggering of ventricular arrhythmias.

In about 30% of patients, there are abnormal vascular responses and inability to increase systolic blood pressure during exercise. This is attributed to exaggerated cardiac inhibitory reflexes initiated by increased myocardial wall stress and to elevated levels of vasodilating substances (natriuretic peptides).


 * Physical examination

The physical findings of HCM are associated with the dynamic outflow obstruction that is often present with this disease.

Upon auscultation, the heart murmur will sound similar to the murmur of aortic stenosis. However, a murmur due to HCM will increase in intensity with any maneuver that decreases the volume of blood in the left ventricle (such as standing abruptly or the strain phase of a Valsalva maneuver). Administration of amyl nitrite will also accentuate the murmur by decreasing venous return to the heart. Classically, the murmur is also loudest at the left parasternal edge, 4th intercostal space, rather than in the aortic area.

If dynamic outflow obstruction exists, physical examination findings that can be elicited include the pulsus bisferiens and the double apical impulse with each ventricular contraction. These findings, when present, can help differentiate HCM from aortic stenosis. In addition, if the individual has premature ventricular contractions (PVCs), the change in the carotid pulse intensity in the beat after the PVC can help differentiate HCM from aortic stenosis. In individuals with HCM, the pulse pressure will decrease in the beat after the PVC (Brockenbrough–Braunwald–Morrow sign), while in aortic stenosis, the pulse pressure will increase. However, post-PVC left ventricular systolic pressure and murmur intensity increase in both aortic stenosis as well as HCM.

-- Jytdog (talk) 06:09, 19 October 2017 (UTC)

Needs a rewrite per MEDMOS
Too much of this is written as advice to doctors, telling them how to treat patients. This needs to be revised per MEDMOS, addressed to everybody. Jytdog (talk) 01:12, 23 October 2017 (UTC)

Feline hypertrophic cardiomyopathy
Feline hypertrophic cardiomyopathy - do you have plans for this part of the page?Sofia Hanås (SLU) (talk) 14:05, 15 May 2020 (UTC)
 * Wikipedia is written by volunteers who rarely announce their plans for the future. I see you are a subject expert, so why dont you be WP:BOLD and if you have material that is reliably sourced, (see WP:RS and WP:MEDRS) why not add it yourself. I see that you are pretty new here, so I'll leave a welcome message on your Talk page with some hopefully useful links for beginners. If you are worried about doing something wrong in a new environment, dont be, there are lots of experienced editors who will help. -Roxy the effin dog . wooF 14:19, 15 May 2020 (UTC)
 * Thank you Roxy the dog.Sofia Hanås (SLU) (talk) 14:27, 15 May 2020 (UTC)

"External" causes?
Can this condition be caused by external causes, such as drugs, chemicals, poisons, and also infections like bacteria, viruses, etc...?107.195.106.201 (talk) 18:40, 15 April 2022 (UTC)
 * It is genetic, inherited. Have you read the article? -Roxy the grumpy dog . wooF 18:47, 15 April 2022 (UTC)
 * Wikipedia does not give medical advice. -  FlightTime  ( open channel ) 18:51, 15 April 2022 (UTC)
 * I'm curious as to why you posted to this thread, User:FlightTime. -Roxy the grumpy dog . wooF 20:22, 15 April 2022 (UTC)
 * Simple, I wanted to. Why? -  FlightTime  ( open channel ) 20:27, 15 April 2022 (UTC)
 * Because nobody is asking for, or giving, medical advice here. -Roxy the grumpy dog . wooF 11:39, 16 April 2022 (UTC)

State of the art review
10.1016/j.jacc.2021.11.021 JFW &#124; T@lk  12:35, 26 January 2023 (UTC)

hocm 163.182.28.136 (talk) 11:55, 5 June 2023 (UTC)