Idiopathic hypertrophic cardiomyopathy in diyala: echocardiographic analysis of 12000 adolescents and adults


This study was conducted in diyala governorate, with echocardiographic analysis of 12000 subjects to determine the clinical and epidemiological aspects of HCM from 1999-2005. Six thousands person were healthy and Six thousands patients who presented with cardiac complaints. Age range of the sample was 15-70 year, patients with known cardiac diseases or taking cardiac drugs were excluded. Thorough clinical history, physical examination, electrocardiography (ECG), chest radiographs, echocardiography (M-mode, two dimensional B-mode and continues wave (CW) Doppler mode) and standardized laboratory tests were performed .Our study showed that among 12000 persons screened 18 cases of proved HCM were diagnosed (0.15%),10 males(0.0833%) and 8 females(0.0666%),six cases 33.3% (3 males(50%) and 3 females (50%) were asymptomatic at diagnosis. Among six thousands patients presented with cardiovascular complaints (chest pain, dyspnea, palpitation, features of heart failure, pre-syncope and syncope) twelve (12) cases (0.01%) were diagnosed, seven males (58.3%) and five females (41.6%). Most of cases were in young age group: Fourteen patients (77.7%) were (20-39) years of age, and only 1<20 and 3 >40, male/female ratio was 1.25:1. Fourteen patients 77.7% were in NYHA -1 functional class and 5 patients (27.7%) had positive results on family screening for HCM. Echocardiographic study showed that fifteen patients (83.3) had asymmetrical septal hypertrophy (ASH) and 3 patients (16.6%) had concentric LVH. Doppler echocardiography showed substantial obstruction to left ventricular outflow tract (LVOT) in 7 (38.8%) patients (the range of the mean peak systolic pressure gradient was from 30 to 71 mm Hg: Hypertrophic obstructive cardiomyopathy. Thirteen subjects (72.2%) had abnormal ECG,atrial fibrillation reported in one patient (5.5%) .The estimated total prevalence of HCM in diyala governorate is 0.15% (150/100000).