Differential Diagnosis
- Single most likely diagnosis + Hypertrophic Obstructive Cardiomyopathy (HOCM): This condition is characterized by asymmetric septal hypertrophy, which can lead to a significant intracavitary gradient and is often associated with systolic anterior motion (SAM) of the mitral valve. The presence of moderate to severe concentric increased left ventricular wall thickness and an intracavitary gradient of 94mmHg, along with SAM, strongly suggests HOCM.
- Other Likely diagnoses + Hypertensive Heart Disease: Severe hypertension can lead to concentric left ventricular hypertrophy, which may result in increased wall thickness and elevated intracavitary gradients. However, the presence of SAM is less common in this condition. + Athlete's Heart: Intensive athletic training can cause physiological cardiac adaptations, including increased left ventricular wall thickness. However, the intracavitary gradient and SAM are not typical features of athlete's heart.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Cardiac Amyloidosis: This condition can cause concentric left ventricular hypertrophy and may lead to increased intracavitary gradients. Although less common, cardiac amyloidosis can be fatal if left untreated, making it a crucial diagnosis not to miss. + Fabry Disease: A genetic disorder that can cause left ventricular hypertrophy and increased intracavitary gradients. Early diagnosis and treatment are essential to prevent long-term cardiac damage.
- Rare diagnoses + Fabry-Anderson Disease: A rare genetic disorder that affects the heart, causing left ventricular hypertrophy and increased intracavitary gradients. + Danon Disease: A rare X-linked dominant disorder that can cause hypertrophic cardiomyopathy, characterized by increased left ventricular wall thickness and intracavitary gradients. + Glycogen Storage Disease: A rare genetic disorder that can cause cardiac involvement, including left ventricular hypertrophy and increased intracavitary gradients.