HOCM
Report:
Sinus rhythm 57/min
Borderline first degree AV block
PR 0.22”
Right (or northwest) axis deviation +225o
RsR’ V1
Poor R wave progression
Possible right ventricular hypertrophy
Left ventricular hypertrophy voltage
Possible old inferolateral infarction
Comment:
This is a difficult trace to interpret, or even describe. Once the diagnosis of HOCM is known, however, it all falls into place. This patient had an ASH 4 cm and of course no evidence of infarction.
The disease progressed, over two years, into either an atypical LBBB or LAHB with intraventricular conduction delay (Fig 75a). Pathological Q waves remained, but in new positions.
The name HOCM persists, partly because of its parity with COCM, regardless of whether there is any LV outflow obstruction. HCM is hard to pronounce.
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