Vol. 12. Núm. 43.
Páginas 2548-2560 (Noviembre 2017)

Actualización
Generalidades de las miocardiopatías. Miocardiopatía hipertrófica

Overview of cardiomyopathies. Hypertrophic cardiomyopathy

A.M. Iniesta ManjavacasJ.L. López Sendón
Doi : https://10.1016/j.med.2017.10.011
Opciones
Resumen
Introducción

La miocardiopatía hipertrófica es la más frecuente de las miocardiopatías. Se caracteriza por un aumento del grosor del músculo cardíaco, no explicable por condiciones de carga anómalas.

Manifestaciones clínicas

Los pacientes afectos pueden estar asintomáticos, siendo la disnea el síntoma principal en los individuos con clínica. La complicación más grave es la muerte súbita, generalmente debida a arritmias ventriculares malignas.

Diagnóstico

Las técnicas de imagen cardíaca son la base del diagnóstico, al demostrar la hipertrofia miocárdica.

Tratamiento

El primer escalón terapéutico son los fármacos inotrópicos negativos, siendo los betabloqueantes de primera elección en las formas obstructivas. En estas, si la asociación de disopiramida no alivia los síntomas, puede ser necesario recurrir a procedimientos invasivos de reducción del septo interventricular. El desfibrilador implantable, en pacientes seleccionados, es la herramienta clave en la prevención de la muerte súbita.

Palabras clave
Miocardiopatías
Miocardiopatía hipertrófica
Insuficiencia cardíaca
Abstract
Introduction

Hypertrophic cardiomyopathy is the most common type of cardiomyopathy and is characterized by increased heart muscle thickness, that is not explained by abnormal loading conditions.

Clinical manifestations

While affected patients can be asymptomatic, dyspnoea is the main complaint in those with symptoms. The most severe complication is sudden death, generally due to malignant ventricular arrhythmias.

Diagnosis

Cardiac imaging techniques are the basis for the diagnosis, because they demonstrate the myocardial hypertrophy.

Treatment

The first therapeutic approach consists of negative inotropic agents. Beta-blockers are considered to be the first choice in obstructive forms of this disease. If the combination of these agents and disopyramide does not relieve the symptoms, it might be necessary to resort to invasive procedures in order to reduce the interventricular septum. Implantable defibrillators in selected patients are the key toolsto prevent sudden death.

Keywords
Cardiomyopathies
Hypertrophic cardiomyopathy
Heart failure

Identifíquese

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