The diagnosis based on the clinical history is a case of chronic hypertension

The diagnosis based on the clinical history is a case of chronic hypertension, leading to concentric hypertrophy of heart and low LVEF.

✨ Mechanism: Chronic hypertension → increased afterload → increased myocardial wall tension → changes in myocardial gene expression → sarcomeres laid down in parallel → increased left ventricular thickness → decreased left ventricular size → diastolic dysfunction.

✨ The genes implicated here are

  • GATA4

  • NFAT

  • MEF2.

⭐️ P.S. MLL1 (chromosome 11) is associated with acute Leukemia and it indicates poor prognosis due to resistance to chemotherapy.