New concepts in hypertrophic obstructive cardiomyopathy I

Abstract

HYPERTROPHIC obstructive cardiomyopathy is a form of primary myocardial disease with a characteristic clinical and pathological expression. The disorder is referred to by several names. Braunwald and associates¹introduced and popularized the term "idiopathic hypertrophic subaortic stenosis" in the United States, Wigle and associates²coined the term "muscular subaortic stenosis" in Canada, while in Europe it is generally referred to as hypertrophic obstructive cardiomyopathy (HOCM), following the lead of Goodwin and associates³at the Royal Postgraduate School of Medicine in London. A term that includes subaortic stenosis is unfortunate, since the disorder may be expressed without left ventricular outflow obstruction and since patients have been described as having isolated infundibular subpulmonic stenosis. It is more accurate and potentially less confusing to refer to the disorder as hypertrophic cardiomyopathy and add the word "obstructive" if either left or right ventricular outflow obstruction can be demonstrated.⁴The historical aspects of