Differenzialdiagnostik der linksventrikulären Hypertrophie – Abgrenzung und Konsequenzen für Prognose und Therapie

Die linksventrikuläre Hypertrophie kann die Folge zahlreicher Krankheitsentitäten sein. Entscheidend in der Diagnostik ist die Abgrenzung der primären Myokardhypertrophie von den sekundären Hypertrophieformen, da sich hieraus weitreichende Konsequenzen für die Prognose und Therapie der einzelnen Erkrankungen ergeben. Die hypertrophe Kardiomyopathie erfordert eine besonders sorgfältige Diagnostik hinsichtlich der Primärprävention des plötzlichen Herztodes, zumal hier vor allem ein jüngeres Patientenkollektiv betroffen ist. Neben der Anamnese, der Auskultation, dem Elektrokardiogramm und der 2D-Echokardiografie sind so weitere Verfahren wie die Gewebedopplerechokardiografie, die Endomyokardbiopsie sowie die Kontrast-CMR-Untersuchung unverzichtbare Elemente in der differenzierten Diagnostik der linksventrikulären Hypertrophie.

Left ventricular hypertrophy can be a sequel of numerous clinical entities. Decisive for the diagnosis is the delineation of primary myocardial hypertrophy from secondary forms of hypertrophy since this has far-reaching consequences for the prognosis of and therapy for the individual diseases. Hypertrophic cardiomyopathy in particular requires an especially careful diagnosis with regard to the prevention of sudden cardiac death, above all because mainly younger patient collectives are concerned. Besides the case history, ausculation, electrocardiograhy and 2D echo cardiography, further procedures such as tissue Doppler echo cardiography, endomyocardial biopsy as well as contrast-enhanced cardiavascular MRI are indispensable elements in the differential diagnosis of left ventricular hypertrophy.

Key words

left ventricular hypertrophy - differential diagnosis - hypertrophic cardiomyopathy - sudden cardiac death - electrocardiogram - tissue Doppler echo cardiography - endomyocardial biopsy

Literatur

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