Obstructive asymmetric septal hypertrophy

Obstructive Asymmetric Septal Hypertrophy (OASH) is a medical condition characterized by the abnormal thickening of the heart's septum, which is the wall dividing the left and right sides of the heart. This thickening is asymmetric, meaning it is uneven, with a significant portion of the enlargement occurring on one side of the septum. This condition is a subtype of Hypertrophic Cardiomyopathy (HCM), a disease that affects the muscle of the heart, making it harder for the heart to pump blood.

Causes and Risk Factors

The primary cause of OASH is genetic mutations that affect the heart's muscle proteins. These mutations are often inherited, meaning the condition can run in families. Other risk factors may include high blood pressure, aging, and certain medical conditions that put stress on the heart.

Symptoms

Symptoms of OASH can vary widely among individuals. Some people may be asymptomatic, while others may experience significant symptoms, including:

• Shortness of breath, especially during exercise
• Chest pain, often resembling angina
• Palpitations or irregular heartbeats
• Dizziness or fainting spells, particularly with physical activity
• Fatigue

Diagnosis

Diagnosis of OASH involves a combination of medical history, physical examination, and diagnostic tests. Key diagnostic tools include:

• Echocardiogram: An ultrasound of the heart that can visualize the thickened septum and assess its impact on heart function.
• Electrocardiogram (ECG): A test that measures the electrical activity of the heart and can detect abnormalities in heart rhythm.
• Magnetic Resonance Imaging (MRI): Can provide detailed images of the heart's structure, including the septum's thickness.
• Genetic testing: May be recommended for patients with a family history of HCM or OASH.

Treatment

Treatment for OASH focuses on relieving symptoms, preventing complications, and reducing the risk of sudden cardiac death. Options include:

• Medications: Beta-blockers and calcium channel blockers can help manage symptoms by reducing the heart's workload and controlling heart rate.
• Surgical procedures: In severe cases, surgery may be necessary to remove part of the thickened septum (myectomy) or to implant a device to regulate heart rhythm (pacemaker or defibrillator).
• Lifestyle changes: Patients are often advised to avoid strenuous exercise and to manage other risk factors, such as high blood pressure.

Prognosis

The prognosis for individuals with OASH varies. With appropriate management, many people live normal or near-normal lives. However, the condition can increase the risk of serious complications, including heart failure and sudden cardiac death, particularly in those with severe symptoms or inadequate treatment.

See Also

• Cardiomyopathy
• Heart Failure
• Sudden Cardiac Death