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Cardiomiopatia hipertrófica

Last reviewed: 12 Aug 2025
Last updated: 01 May 2025

Summary

Definition

Anamnesis y examen

Principales factores de diagnóstico

  • história familiar de CMH
  • história de pré-síncope ou de síncope
  • sopro sistólico de ejeção
  • elevação ventricular esquerda (ictus)
  • impulso apical duplo ou dupla pulsação da carótida
  • história familiar de morte súbita
Todos los datos

Otros factores de diagnóstico

  • homem mais jovem (<50 anos de idade)
  • dispneia
  • angina
  • palpitações
  • pulso irregularmente irregular
  • mulher de idade mais avançada (>50 anos de idade)
  • colapso
  • quarta bulha cardíaca
Todos los datos

Factores de riesgo

  • história familiar de cardiomiopatia hipertrófica (CMH) ou morte súbita cardíaca
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • eletrocardiograma (ECG)
  • creatina quinase (CK)
  • testes da função hepática
  • testes de função renal
  • Fragmento N-terminal do peptídeo natriurético tipo B (NT-proPNB)
  • troponina
  • urinálise
  • radiografia torácica
  • ecocardiografia transtorácica com Doppler
Todos los datos

Pruebas diagnósticas que deben considerarse

  • eletrocardiografia de esforço
  • monitoramento com Holter
  • teste ergométrico com cintilografia
  • ressonância nuclear magnética cardíaca (RNMC)
  • Tomografia computadorizada cardíaca (TC)
  • arteriografia coronariana por tomografia computadorizada (TC)
  • cateterismo cardíaco
  • ecocardiografia sob estresse
  • ecocardiografia por esforço
  • ecocardiografia transesofágica
  • biópsia endomiocárdica
  • análise de mutações genéticas
Todos los datos

Algoritmo de tratamiento

En curso

assintomático

sintomático: obstrução da via de saída do ventrículo esquerdo com função sistólica preservada (fração de ejeção ≥50%)

sintomático: não obstrutivo com função sistólica preservada (fração de ejeção ≥50%)

sintomático: com disfunção sistólica (fração de ejeção <50%)

Colaboradores

Autores

Theodore Abraham, MD

Professor of Medicine and Radiology

Meyer Friedman Distinguished Professor of Medicine

Co-director, UCSF HCM Center of Excellence

University of California

San Francisco

CA

Divulgaciones

TA serves as a steering committee member/local investigator and his institution has received research funding for hypertrophic cardiomyopathy-related clinical trials sponsored by Bristol Myers Squibb; Cytokinetics Inc.; Tenaya Pharmaceuticals; and Imbria Pharmaceuticals.

Agradecimientos

Dr Theodore Abraham would like to gratefully acknowledge Dr Monica Mukherjee, Dr Melanie D. Everitt, and Dr Anji T. Yetman, previous contributors to this topic.

Divulgaciones

MM, MDE, and ATY declare that they have no competing interests.

Revisores por pares

Radhika Kuna, MD

Fellow

Division of Cardiology

University of Maryland Medical Center

Baltimore

MD

Divulgaciones

RK declares that she has no competing interests.

Saidi Mohiddin, BSc, MBChB

Consultant Cardiologist/Head of Unit

Heart Muscle Disease Unit

Barts and The London NHS Trust

London

UK

Раскрытие информации

SM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Arbelo E, Protonotarios A, Gimeno JR, et al. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023 Oct 1;44(37):3503-626.Полный текст  Аннотация

Writing Committee Members, Ommen SR, Ho CY, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy: a report of the American Heart Association/American College of Cardiology Joint Committee on clinical practice guidelines. J Am Coll Cardiol. 2024 Jun 11;83(23):2324-405.Полный текст  Аннотация

Richard P, Charron P, Carrier L, et al. Hypertrophic cardiomyopathy: distribution of disease genes, spectrum of mutations, and implications for a molecular diagnosis strategy. Circulation. 2003 May 6;107(17):2227-32. [Erratum in: Circulation. 2004 Jun 29;109(25):3258.]Полный текст  Аннотация

O'Mahony C, Jichi F, Pavlou M, et al. A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). Eur Heart J. 2014 Aug 7;35(30):2010-20.Полный текст  Аннотация

Pelliccia A, Sharma S, Gati S, et al. 2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021 Jan 1;42(1):17-96.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Cardiomiopatia hipertrófica images
  • Отличия

    • Coração de atleta
    • Estenose subaórtica distinta
    • HVE causada por hipertensão
    Больше Отличия
  • Diretrizes

    • 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy
    • 2023 ESC Guidelines for the management of cardiomyopathies
    Больше Diretrizes
  • Videos

    Galope de quarta bulha cardíaca

    Mais vídeos
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