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A correction has been published: N Engl J Med 2004;351(10):1038.

Clinical Practice
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Volume 350:1320-1327 March 25, 2004 Number 13
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Hypertrophic Obstructive Cardiomyopathy
Rick A. Nishimura, M.D., and David R. Holmes, Jr., M.D.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 28-year-old man presents with a two-year history of increasing dyspnea on strenuous exertion and is found to have hypertrophic cardiomyopathy, with a septal thickness of 23 mm and a left ventricular outflow gradient of 80 mm Hg. There is no family history of hypertrophic cardiomyopathy or sudden death. Forty-eight-hour Holter monitoring shows infrequent premature ventricular contractions. How should this patient be . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnostic Evaluation

Pharmacologic Therapy

Other Interventions

            Surgical Septal Myectomy

            Implantation of a Dual-Chamber Pacemaker

            Alcohol-Induced Septal Ablation

Risk of Sudden Death

Other Complications

Guidelines

Areas of Uncertainty

Conclusions and Recommendations


Source Information

From the Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, where reprint requests should be addressed to Dr. Nishimura.


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