[Hypertrophic cardiomyopathy: variants of the clinical picture].

The authors describe a variety of the clinical manifestations of hypertrophic cardiomyopathy (HTCM) and identify the most frequent variants of its clinical picture, namely pseudocoronary, pseudorheumatic, dystonic. A number of symptoms and their combinations indicative of the presence of the HTCM are also described. The key role of echocardiography in the diagnosis of this disease was demonstrated. The syndrome of giant negative T waves was observed in 35% of the patients with the HTCM; this syndrome was shown to correlate with the predominance of hypertrophy in the apical area. A correlation was established between the echocardiographic signs of impairment of the diastolic pliability of the left ventricle and the presence of circulatory failure. The authors discuss the role of myocardial ischemia in the genesis of pains and ECG changes in patients with the HTCM as well as the significance of research into the myocardial metabolism in the diagnosis of myocardial ischemia in this category of patients.