(Second of Two Parts)

Interrelation between Pathophysiologic Mechanisms and Disease Manifestations

Symptoms

The chief symptoms of hypertrophic cardiomyopathy are exertional angina, dyspnea, fatigue, and impaired consciousness (transient spells of lightheadedness, near-syncope, and syncope). However, a direct, one-to-one correlation between a particular symptom and a single pathophysiologic mechanism does not always exist. For example, in a population of patients with hypertrophic cardiomyopathy, a general relation exists between the severity of symptoms and the magnitude of left ventricular hypertrophy¹⁹; however, this correlation is not absolute, and some patients with mild and localized hypertrophy may have severe symptoms,³⁶ whereas other patients with . . .