SPEAKERS: Perry Elliott and Paolo Camici
The ESC Webinars are designed to help you improve your daily practice!
The format includes a case based presentation, online assesssment and live discussions with the two key opinion leaders who will deliver useful tips for your daily clinical practice.
In 2008, The ESC Working Group on Myocardial and Pericardial Diseases proposed an updated classification of cardiomyopathies based on morphological and functional phenotypes and sub-categories of familial/genetic and non-familial/non genetic disease. In this presentation we show how this proposed framework for the clinical approach to diagnosis based on the recognition of diagnostic red flags that can be used to guide rational selection of specialised tests including genetic analysis. The basic premise is that the adoption of a cardiomyopathy specific approach that combines conventional cardiological assessment with non-cardiac and molecular parameters increases diagnostic accuracy and improves advice and treatment for patients and families.
Approximately 25% of patients have obstruction to the LV outflow tract at rest and as many as 70% may have latent or provocable LV outflow tract obstruction caused by contact between the anterior mitral valve leaflet and the ventricular septum during systole. LV outflow tract obstruction is detected using colour flow Doppler and quantified using continuous wave Doppler. Most patients with systolic anterior motion of the mitral valve and LV outflow tract obstruction have a posteriorly directed jet of mitral regurgitation, which can be detected using colour Doppler imaging. The presence of complex mitral regurgitant jets (e.g. anteriorly-directed or central) may indicate the presence of primary mitral valve abnormalities. The mechanisms of obstruction, their assessment and treatment will be reviewed. Factors that determine selection of patients for medical or interventional therapy with surgery, septal alcohol ablation or pacing will be discussed.
Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, Dubourg O, Kühl U, Maisch B, McKenna WJ, Monserrat L, Pankuweit S, Rapezzi C, Seferovic P,Tavazzi L, Keren A. Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008 Jan;29(2):270-6.
Charron P, Arad M, Arbustini E, Basso C, Bilinska Z, Elliott P, Helio T, Keren A, McKenna WJ, Monserrat L, Pankuweit S, Perrot A, Rapezzi C, Ristic A, Seggewiss H, van Langen I, Tavazzi L; European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Genetic counselling and testing in cardiomyopathies: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2010 Nov;31(22):2715-26.
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