Andererseits können auch lebensbedrohliche Herzrhythmusstörungen als Komplikation auftreten. [su_box title=”Sudden Death Risk Calculator” style=”soft” box_color=”#1E73BE” radius=”13″]European Society of Cardiology HCM Sudden cardiac death risk calculator[/su_box]. This is called an exercise stress test. It also shows how well your heart's chambers and valves are pumping blood. Like many people with this condition, you may experience feelings of grief, fear and anger. Hypertrophic cardiomyopathy (HCM) is the most common inherited monogenic cardiac disorder, affecting 0.2-0.5% of the population. Others develop symptoms that can progress. But in the hands of expert centers, the complication rates are very low and our success rates are very high. Die Symptome der hypertrophen Kardiomyopathie sind den Symptomen der Aortenstenose ähnlich ( Tab. Cardiac hypertrophy is usually asymmetrical with greatest involvement most commonly of the basal interventricular septum subjacent to the aortic valve. B. arterielle Hypertonie, Klappenerkrankungen) allein erklärt werden kann. Veröffentlicht: 10.12.2015, 12:44 Uhr This muscle doesn't regrow over time. Mayo Clinic facts about coronavirus disease 2019 (COVID-19), Our COVID-19 patient and visitor guidelines, plus trusted health information, Mayo Clinic Health System patient vaccination updates, for video Hypertrophic cardiomyopathy and treatment options, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Our caring team of Mayo Clinic experts can help you with your hypertrophic cardiomyopathy-related health concerns, Implantable cardioverter-defibrillators (ICDs), Video: Septal myectomy and apical myectomy, Mayo Clinic Q and A: Hypertrophic cardiomyopathy, FREE book offer — Mayo Clinic Health Letter, Time running out - 40% off Online Mayo Clinic Diet ends soon. Hypertrophic cardiomyopathy (HCM) is a condition in which the heart becomes thickened without an obvious cause. Shortness of breath. Die Hypertrophe Kardiomyopathie (HCM) ist eine Erkrankung, welche durch eine Verdickung des Herzmuskels gekennzeichnet ist. Diagnosis of hypertrophic cardiomyopathy was based on the presence of left ventricular hypertrophy without a known cause. What Symptoms Does Hypertrophic Cardiomyopathy Cause? The goal of hypertrophic cardiomyopathy treatment is to relieve symptoms and prevent sudden cardiac death in people at high risk. Some people who have cardiomyopathy never have symptoms, while others may show signs as the disease progresses. Nature Clinical Practice Cardiovascular Medicine. It is possible for infants to born with thick heart muscles, but that's really quite rare and usually more severe expressions of the disease. Use of this website implies understanding and acceptance of its, European Society of Cardiology HCM Sudden cardiac death risk calculator. Fainting, especially during or just after exercise or exertion 4. Designed by Elegant Themes | Powered by WordPress, All Rights Reserved. Hypertrophe Kardiomyopathie (HKM) bedeutet übersetzt krankhafte Vergrößerung des Herzmuskels. In the past, HCM was considered a rare disorder associated with a poor prognosis but more recent population screening studies suggest that it is actually common (1:500 individuals). And allows blood to leave the heart without increasing pressures or increasing forces. Swelling in the ankles and legs. Hartzell V. Schaff: We now do a more extensive septal myectomy that extends towards the apex of the heart. Auch die arrhythmogene rechtsventrikuläre Kardiomyopathie hat keine gute Prognose. A doctor listens to a person's heart at Mayo Clinic. https://www.uptodate.com/contents/search. hypertrophe Kardiomyopathie ist eine Pathologie des Myokard, bei dem das Gewicht erhöht und die Dicke des Herzmuskels, die oft - im linken Ventrikel, kann aber in den rechten Seite, und in der Scheidewand sein. 4. When did you begin experiencing symptoms, and how severe are they? 3 As diagnostic and therapeutic paradigms for HCM … These might include the following: 1. Accessed March 27, 2020. Prinzipiell geht man bei einem AV-Block ohne erkennbare Ursache aber eher von einer guten Prognose aus. inherited disease that affects certain proteins within heart muscle cells The annual cardiac mortality was 1% (95% confidence interval 0.2-1.8%). Es besteht ein autosomal-dominanter Erbgang mit variabler Penetranz, sodass in circa 50 % der Fälle eine familiäre Häufung auftritt [6, 7]. Basu J, et al. Die familiäre hypertrophe Kardiomyopathie (HCM) ist eine genetische Erkrankung des sarkomeren Apparats mit meist autosomal-dominantem Erbgang und ist in der Regel durch eine asymmetrische Hypertrophie des linken Ventrikels (seltener des rechten Ventrikels) gekennzeichnet. How often will I need follow-up appointments? Verdickung der Muskulatur. Hartzell V. Schaff: Over 2/3 of the patients will have obstruction. Die Hypertrophe Kardiomyopathie ist charakterisiert durch eine meist asymmetrische Verdickung (Hypertrophie) der Muskulatur der linken Herzkammer. Dearani JA, et al. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Ursachen der hypertrophen Kardiomyopathie. Laut Studien leben … Für die hypertrophe Kardiomyopathie (HCM) ist eine Verdickung der linken Herzkammermuskulatur charakteristisch. Click to enlarge. Use of this website implies understanding and acceptance of its disclaimer and privacy policy.Funding to build and maintain this site is provided by Dr. T. Sloane Guy, MD. Advertising revenue supports our not-for-profit mission. Accessed March 27, 2020. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Heart murmur, which a doctor might detect while listening to your heart Hartzell V. Schaff: Septal myectomy cures the symptoms of hypertrophic cardiomyopathy when it relieves the obstruction. Some people with the condition can lead a normal life and remain essentially symptomatic. μυς mys, Muskel, gr. http://www.heart.org/HEARTORG/Conditions/More/Cardiomyopathy/Prevention-and-Treatment-of-Cardiomyopathy_UCM_444176_Article.jsp#.WbbYzdjrvcs. mild hypertension or mild aortic stenosis with marked hypertrophy). durch eine Bluthochdruck­erkrankung oder einen Herzklappen­fehler ist. Mayo Clinic does not endorse companies or products. Die Verdickung kann die gesamten Herzmuskeln, aber auch nur Teilabschnitte umfassen. Accessed April 23, 2020. So we know now that 2/3 of the patients with hypertrophic cardiomyopathy and obstruction are candidates for surgery. American Heart Association. Bonow RO, et al., eds. http://www.heart.org/HEARTORG/Conditions/More/Cardiomyopathy/Hypertrophic-Cardiomyopathy_UCM_444317_Article.jsp#.WbMHH9jrvIU. Men and women have the condition at the same frequency. Most people with this condition do not have any symptoms. Hartzell V. Schaff: We found that it's rarely necessary to do something to the mitral valve. 21 Ihre Ansprechpartner 22 Impressum 24 | 03. Being diagnosed with hypertrophic cardiomyopathy can cause a range of difficult emotions. Even in the absence of symptoms, familial HCM can have serious consequences such as life-threatening arrhythmias, heart failure, and an Symptoma. It allows the mitral valve to function normally. Hypertrophic cardiomyopathy (HCM) is a genetically determined heart muscle disease most often (60 to 70 percent) caused by mutations in one of several sarcomere genes which encode components of the contractile apparatus of the heart. Together, you and your doctor will discuss the most appropriate treatment for your condition. 3. Bei höherem Erkrankungsgrad ist der Verlauf variabel und es wurden bestimmte Risikofaktoren für das Entstehen des kongestiven Herzversagens und der Aortenthrombose identifiziert. indexmarketsresearch November 19, 2020. Circulation. Medications can help reduce how strong the heart muscle squeezes and slow the heart rate so that the heart can pump blood better. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Während Patienten mit einer mild ausgeprägten hypertrophen Kardiomyopathie eine nahezu normale Lebenserwartung haben, verlaufen die dilatative und die restriktive Kardiomyopathie weit schlechter. The most concerning thing that can happen is sudden cardiac arrest (SCA) which is more common in younger patients. In the United States alone, there are over a half a million people that have hypertrophic cardiomyopathy, many of whom are completely asymptomatic and unaware of their diagnosis. Your doctor will examine you and ask questions about your signs, symptoms, and medical and family history. Steve R. Ommen: Hypertrophic cardiomyopathy is the most common inherited cardiomyopathy or heart muscle disease. Several different surgeries or procedures are available to treat cardiomyopathy or its symptoms. However, if you have hypertrophic cardiomyopathy, your doctor may recommend that you see a doctor experienced in caring for women with high-risk conditions during your pregnancy. Haben sich jedoch bereits gefährliche Blutgerinnsel (Thrombembolien) gebildet, wird das Katzenleben zur schmerzhaften Qual. Our caring team of Mayo Clinic experts can help you with your hypertrophic cardiomyopathy-related health concerns Die Hypertrophe kardiomyopathie der Katze kann sich selten in einer End-stage HCM manifestieren, die häufig zum kongestiven Herzversagen führt und eine sehr schlechte Prognose hat. The prognosis for hypertrophic cardiomyopathy is very specific to an individual and their particular anatomy. Survival of patients with obstructive hypertrophic cardiomyopathy is much higher with successful myectomy. Von einer hypertrophen Kardiomyopathie … They range from open-heart surgery to implantation of a device to control your heart rhythm. 1,2 In the United States, 750,000 people are estimated to have HCM; however, only approximately 100,000 people have been diagnosed, signifying a large gap in the recognition and understanding of this disease. Hypertrophe Kardiomyopathie. Bisher ist zur Prognose von jüngeren Patienten mit AV-Blockierungen wenig bekannt. Hypertrophe Kardiomyopathie (HOCM): Mehr zu Symptomen, Diagnose, Behandlung, Komplikationen, Ursachen und Prognose lesen. But of course, patients still have hypertrophic cardiomyopathy, still need to be followed by their physician for the other problems related to hypertrophic cardiomyopathy. This content does not have an Arabic version. Some people with the condition can lead a normal life and remain essentially symptomatic. And this is shown in studies that look at defibrillator discharges and rates of sudden death. Hypertrophic cardiomyopathy care at Mayo Clinic. Always call 999 if you or someone else experiences these. Die Website informiert über Herzerkrankungen von … Steve R. Ommen: The inheritance pattern of hypertrophic cardiomyopathy is autosomal dominant, which means each of the children of a patient with HCM has a 50/50 chance of inheriting this disease. Gesundes Herz Hypertrophe Kardiomyopathie-gestörte Architektur der Myozyten-Interstitielle Fibrose-Strukturdefekte des Sarkomers-Gestörter Zell zu Zell Kontakt Myokardbiopsie . Hartzell V. Schaff: One of the things we've learned after doing septal myectomy is that actually the incidence of ventricular arrhythmia seems to be reduced. Wenn der Zustand des Patienten sich durch Medikamente nicht ausreichend bessert, erwägen die Ärzte nicht selten eine Herztransplantation. All rights reserved. When the condition is more severe, you can be breathless at rest. Invasive Behandlung nur bei schwerer Obstruktion und heftigen Symptomen. Patienten mit einer hypertrophen obstruktiven Kardiomyopathie (HOCM) scheint es langfristig besser zu gehen, wenn sie früher als von den Leitlinien empfohlen eine chirurgische Myektomie erhalten. Klinikum Bielefeld-Mitte Seidman, N Engl J Med 1997 Gendefekte bei HCM-Unterschiedliche Prognose-Sehr variable Gen-Penetranz (modifier genes?) Hypertrophic cardiomyopathy also causes abnormal heart cells that are disorganized and, in some cases, scarred. Saunders Elsevier; 2019. https://www.clinicalkey.com. Surgery insight: Septal myectomy for obstructive hypertrophic cardiomyopathy — The Mayo Clinic experience. Viele Katzen mit hypertropher Kardiomyopathie mit geringem oder mäßigem Schweregrad bleiben über Jahre symptomfrei. Beta blockers such as metoprolol (Lopressor, Toprol-XL), propranolol (Inderal, Innopran XL) or atenolol (Tenormin), Calcium channel blockers such as verapamil (Verelan, Calan SR,) or diltiazem (Cardizem, Tiazac), Heart rhythm drugs such as amiodarone (Pacerone) or disopyramide (Norpace), Blood thinners such as warfarin (Coumadin, Jantoven), dabigatran (Pradaxa), rivaroxaban (Xarelto) or apixaban (Eliquis) to prevent blood clots if you have atrial fibrillation. Hypertrophic cardiomyopathy (adult). Hypertrophe Kardiomyopathie: Krankheitsverlauf und Prognose Die hypertrophe Kardiomyopathie hat eine bessere Prognose als viele andere Formen einer Herzmuskelerkrankung. Neben einer asymmetrischen Verdickung des linken Ventrikels liegt bei der Krankheit eine Ausweitung der Herzkammern vor. Prevention and treatment of cardiomyopathy. Nov. 14, 2019. National Heart, Lung, and Blood Institute. In one type, called apical myectomy, surgeons remove thickened heart muscle from near the tip of the heart. Others may get worse slowly or quickly. Treatment will vary depending on the cat's … Eher selten ist die rechtsventrikuläre Verdickung zu erkennen, wobei für den Ausbruch der Erkrankung keine Ursache festgestellt werden kann. Zwar sind diese Krankheitsbilder bei Kindern und Erwachsenen prinzipiell gleich, jedoch gibt es Unterschiede bei den Häufigkeiten des Auftretens, der Symptomatik, der Therapie und der Prognose.Tr Accessed March 27, 2020. Prognose und Vererbung 17 Leben mit einer HCM 18 Forschungsgebiete und Studien im ICH. And in some patients, to allow them to get off of the medications that are having unwanted side effects. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Septal myectomy helps improve blood flow out of the heart and reduces backward flow of blood through the mitral valve (mitral regurgitation). Die hypertrophe Kardiomyopathie (HCM) ist eine seltene angeborene, vererbte Erkrankung des Herzmuskels. This may develop only when you exercise if the condition is mild. Here's some information to help you prepare for your appointment. an inherited condition called hypertrophic cardiomyopathy which causes a thickening of the heart muscle, especially the wall between the two ventricles. Kardiomyopathie (Herzmuskelerkrankungen): Mehr zu Symptomen, Diagnose, Behandlung, Komplikationen, Ursachen und Prognose lesen. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Einwohner ist von der Erkrankung betroffen) die häufigste genetisch bedingte Herzerkrankung. Zu den entzündlichen Herzerkrankungen des Kindes gehören die Endokarditis, Myokarditis und Perikarditis. Symptome . And certainly the symptoms can occur throughout life. The mortality for the procedure is less than 1%, especially for patients who are otherwise healthy. Globale Therapeutika für hypertrophe Kardiomyopathie (HCM) Branchenstatistik & Prognose bis 2025 | AstraZeneca, Concordia International, Gilead Sciences, Merck, Mylan. In this context, the applicability of conventional HCM risk stratification can be challenged given … Steve R. Ommen: With surgical myectomy, the surgeon removes a portion of the hypertrophied septum, which is narrowing the path of blood, out of the heart. Chest pain (angina). Die hypertrophe Kardiomyopathie – kurz HCM – ist die zweithäufigste Form der Herzmuskelerkrankungen und zeigt sich durch eine Verdickung der Wände des linken Ventrikels. American Heart Association. Hypertrophe Kardiomyopathie. Bei der hypertrophen obstruktiven Kardiomyopathie (HOCM) ... Prognose bei einer HOCM. It will help your doctor to know as many details as possible about your family medical history. It involves removing part of the thickened, overgrown wall (septum) between the heart chambers. We can tell if the mitral regurgitation is relieved immediately after the myectomy once the aorta is closed and the heart is restarted. Die Herzmuskulatur ist nach außen durch den sie umgebenden, sehr straffen Herzbeutel (Perikard) begrenzt. It's really not a regrowth of muscle. How will other conditions that I have or medications I take affect my heart problem? Prognose Wird eine hypertrophe Kardiomyopahtie rechtzeitig erkannt, ist die Aussicht auf ein langes und zufriedenes Katzenleben hoch. The few patients who have had a second operation, who have been referred to us after having an operation that was unsuccessful, we found that the myectomy was not carried far enough into the ventricle. Prognose und Prävention. If so, how? Hypertrophic cardiomyopathy (HCM) is diagnosed on the basis of left ventricular hypertrophy (LVH) for which there is insufficient explanation (e.g. You may be referred to a doctor trained in diagnosing and treating heart conditions (cardiologist). Steve R. Ommen: One of the biggest parts of every interaction that I have with patients is helping them understand what their individual risk for sudden cardiac death might be, and whether they might consider having an implantable defibrillator. In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment. However, it is not utilized as much as it maybe could be in part owing to prior perceptions about increased risk with the operation, lack of universal availability of surgeons who can do it. Ohne Herztransplantation stirbt ein großer Teil der Patienten in den ersten zehn Jahren nach der Diagnose. Please follow all recommended Centers for Disease Control and Prevention guidelines for masking and social distancing. Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease with symptoms common to other cardiac (and pulmonary) conditions. Start Here. 04 | Institut für Cardiomyopathien Heidelberg | 05 Die hypertrophische (hypertrophe) Cardiomyopathie (HCM) ist eine Herzmuskelerkrankung, bei der sich der Herzmuskel ohne zunächst offensichtliche Ursache ver-dickt. Schedule your appointment now for safe in-person care. COVID-19: GERINGES Risiko Test starten. Die durchschnittliche Lebenserwartung der Betroffenen liegt bei 66 Jahren, wobei die Prognose abhängig von der zugrunde liegenden molekularen Ursache ist. Jedenfalls haben diese Erfahrung Kardiologen um Dr. Alaa Alashi gemacht. Beschreibung; Test; HOCM. Some of those patients have diastolic heart failure related to very small ventricular cavities. Wenn Sie jedoch keine Therapie durchführen, kann dies zum Tod führen. This site, for healthcare professionals, addresses the potentially chronic and debilitating symptoms and serious complications that can present in … Of particular note, it can occur in young athletes, often during or just following intense physical activity. Recent data that have come out have suggested that at low, medium, and even quote unquote "high volume" centers, there is a gradient of mortality, meaning it's highest at the low volume centers and lowest at the high volume centers. Eine Hypertrophe Kardiomyopathie muss nicht immer zwingend zu klinischen Symptomen und einer Einschränkung der Gesundheit der Katze führen. Usually, that's adding specific medications, but sometimes patients are on medications that can make their situation worse. Allscripts EPSi. Irregular heart beat or palpitations. Mayo Clinic is a not-for-profit organization. In a type called apical myectomy, the thickened area is removed from the area near the tip of the heart. Riggin EA. Bei einer hypertrophen obstruktiven Kardiomyopathie müssen sich nicht zwingend Beschwerden bemerkbar machen. 2. For patients who don't respond to those medical changes, or for whom those medications caused side effects that are intolerable, then that's when we move to things like surgical myectomy, which can more definitively relieve their symptoms. Hypertrophic cardiomyopathy is the most commonly diagnosed cardiac disease in cats. A single copy of these materials may be reprinted for noncommercial personal use only. This open-heart surgery may be recommended if medications do not improve your symptoms. Hypertrophic cardiomyopathy is a well-known cause of sudden death in athletes. Patients with hypertrophy limited to the basal septum represented a special clinical subtype of obstructive hypertrophic cardiomyopathy showing better clinical outcomes, while diffuse hypertrophy of the ventricular septum and free wall indicated lower survival after surgical myectomy. Maron MS. Hypertrophic cardiomyopathy: Management of ventricular arrhythmias and sudden cardiac death risk. Medications to treat hypertrophic cardiomyopathy and its symptoms may include: A septal myectomy is an open-heart procedure in which the surgeon removes part of the thickened, overgrown septum between the ventricles, as shown in the heart on the right. Betroffen ist circa einer von 500 – 1 000 Einwohnern [7]. The reason for the onset of symptoms is often not clear. Eine optimale Vorsorge ist daher unablässig für ein gutes Wohlbefinden Ihrer Katze. Some people with hypertrophic cardiomyopathy may not have symptoms and will have normal lifespan. And we've learned over the years that it's this distal portion of myectomy that's the most important in terms of relieving symptoms. Hypertrophic cardiomyopathy (HCM) is a genetic disorder of cardiac myocytes that is characterized by cardiac hypertrophy, unexplained by the loading conditions; a nondilated left ventricle; and a normal or increased ejection fraction. When a family has chosen to use echocardiography as their screening tool, we recommend that adult first-degree relatives get screened every five years. Sie kann sogar völlig ohne Beschwerden bleiben, vor allem dann, wenn sie den Blutfluss durch die Aortenklappe nicht stört. And this is a procedure that should be done by those who are very familiar with this procedure, and doing a lot of them. Bislang wurden im … Hypertrophe Kardiomyopathie. Informationen über die hypertrophe Kardiomyopathie, die häufigste Herzerkrankung bei Katzen für Tierbesitzer der Tierkardiologie der Ludwig Maximilians Universitaet Muenchen; Infos über Diagnose, Therapie und Prognose. Have your symptoms changed over time? Mayo Clinic. Symptoms may occur at any stage in a person’s life even though the condition may have been present for some time. B. aufgrund von valvulärer Aortenklappenstenose, Koarktation der Aorta, systemische Hypertonie) charakterisiert ist. Survival, on average, is only a few months. And so some of the most effective therapy is removing the wrong agents, and then perhaps having to add in the right agents to help them with their symptoms down stream. Definition:Hypertrophe Kardiomyopathie ist definiert durch das Vorliegen einer erhöhten linksventrikulären Wanddicke, die nicht durch abnorme Ladebedingungen (z. https://www.nhlbi.nih.gov/health/health-topics/topics/cm. Hartzell V. Schaff: The patients who are referred for surgery almost always have either failed medical treatment or have side effects from the medicines that limit them just as much as the symptoms from hypertrophic cardiomyopathy. This test uses sound waves (ultrasound) to see if your heart's muscle is abnormally thick. What's the most likely cause of my symptoms? First-degree relatives who are adolescents or athletes, we usually screen every 12 to 18 months. Accessed March 27, 2020. The surgery may be done using different approaches, depending on the location of the thickened heart muscle. But hopefully, are relieved of the shortness of breath, chest pain, or light-headedness that leads to the operation. 11th ed. We do 200 to 250 operations each year. This site does not host or receive funding from advertising. Note: This content was created prior to the coronavirus disease 2019 (COVID-19) pandemic and does not demonstrate proper pandemic protocols. Anschließend beobachtete man sie im Schnitt acht Jahre lang. Sometimes the condition causes few or no symptoms. However, they should be treated in specialized treatment centers like ours that have dedicated themselves to a team approach to the disease and put your needs at the top of the priority list. When to Contact a Medical Professional Call your provider if: You have any symptoms of hypertrophic cardiomyopathy. But even those so-called high volume centers have mortality rates that are dramatically higher than what is reported from the true expert centers. Bei einem Teil der Fälle kommt es zu einer unter Belastung zunehmenden Verengung (Obstruktion) der linksseitigen Ausflussbahn (Hypertrophe obstruktive Kardiomyopathie, HOCM) und im Verlauf zu einer Versteifung (mit verminderter … If exercise makes your symptoms worse, avoid strenuous exercise until you have seen your doctor and received specific exercise recommendations. J Am Coll Cardiol 46: 470-476. Sometimes the mitral valve is repaired at the same time. Diese Verdickung kann die gesamte Herzmuskulatur oder auch nur einzelne Bereiche des Herzmuskels betreffen. The content of this site reflects my personal opinions and not necessarily those of Jefferson Health or Sidney Kimmel Medical College. Possible symptoms include the following: 1. Die Prognose der DCM ist schlecht, die 10-Jahres-Überlebensrate beträgt nur 20 %. Some people can die suddenly. Es kommt also zu einer Vergrößerung bzw. Hypertrophic cardiomyopathy. Fewer ApHCM patients report a positive family history compared with classic HCM,5 potentially suggesting differences in ascertainment screening and/or different etiological (genetic, environmental) factors. Others develop symptoms that can progress. Im Vergleich zu Kontrollprobanden war die Durchblutung nach Dipyridamol-Gabe bei den Patienten … Sie ist charakterisiert durch eine meist asymmetrische Verdickung (Hypertrophie) der Muskulatur der linken Herzkammer über 15 mm ohne adäquate Druckbel… And the hazard with doing something to the mitral valve, where it turns out to be unnecessary, is there is a chance of injury.