About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
SAM in Cardiology
Introduction
Systolic Anterior Motion (SAM) is a condition affecting the heart's mitral valve and left ventricle. It is most commonly seen in patients with Hypertrophic Cardiomyopathy (HCM) , where the mitral valve's leaflets move abnormally toward the septum during systole (heart contraction). This can lead to left ventricular outflow tract (LVOT) obstruction , reducing blood flow from the heart.
Causes and Risk Factors
- Hypertrophic Cardiomyopathy (HCM) – The most frequent cause.
- Structural abnormalities of the mitral valve – Elongated valve leaflets can contribute to SAM.
- Hyperdynamic circulatory states – Conditions like dehydration or high-stress states.
- Post-surgical or congenital heart conditions .
Symptoms
Patients with SAM often experience: - Shortness of breath (dyspnea) - Chest pain - Dizziness or fainting (syncope) - Palpitations (irregular heartbeats)
Diagnosis
- Echocardiography (especially Doppler imaging) to visualize abnormal mitral valve movement.
- Cardiac MRI to evaluate heart structure.
- Electrocardiogram (ECG) to detect associated arrhythmias.
Treatment Options
1. Medications
- Beta-blockers (e.g., metoprolol) – Reduce heart contraction force, decreasing SAM severity.
- Calcium channel blockers (e.g., verapamil) – Relax the heart muscle.
- Avoidance of diuretics – These may exacerbate obstruction.
2. Surgical & Interventional Procedures
- Septal Myectomy – Surgical removal of excess ventricular muscle to reduce obstruction.
- Alcohol Septal Ablation (ASA) – A less invasive procedure to reduce thickened heart muscle.
- Mitral Valve Surgery – In severe cases, mitral valve repair or replacement may be needed.
3. Lifestyle Modifications
- Avoid dehydration and excessive alcohol.
- Be cautious with intense exercise; consult a cardiologist before engaging in high-level sports.
Conclusion
SAM is a serious cardiac condition that requires timely diagnosis and management, often linked to Hypertrophic Cardiomyopathy. With proper treatment, many patients can lead active and fulfilling lives.
Source recommendations
1. 2023 AHA/ACC Guideline for the Management of Hypertrophic Cardiomyopathy
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001250
- https://www.jacc.org/doi/10.1016/j.jacc.2024.04.002
- https://pubmed.ncbi.nlm.nih.gov/38718139/
- https://www.jacc.org/guidelines/hcm
- https://professional.heart.org/en/science-news/2024-guideline-for-the-management-of-hypertrophic-cardiomyopathy
2. 2024 ESC Guidelines on Hypertrophic Cardiomyopathy
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiomyopathy-Guidelines
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001250
- https://www.jacc.org/doi/10.1016/j.jacc.2024.04.002
- https://academic.oup.com/eurheartj/article/45/Supplement_1/ehae666.2024/7836969
- https://pubmed.ncbi.nlm.nih.gov/39520615/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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