Loss of mid-cavity gradient in hypertrophic cardiomyopathy following myocardial infarction: blessing in disguise

Hypertrophic cardiomyopathy (HCM) is characterised by a heterogeneous clinical expression, unique pathophysiology and diverse natural history. Longstanding left ventricular (LV) outflow tract obstruction is a strong determinant of HCM-related progressive heart failure and cardiovascular death. Here we report the clinical features and natural history of a young female with HCM and mid-cavity obstruction who became symptomatically better after apical myocardial infarction which resulted in the loss of mid-cavity obstruction. A 40-year-old woman presented with a history of progressive worsening of dyspnoea on exertion over the previous 6 months. She had been diagnosed with hypertrophic obstructive cardiomyopathy at the age of 28 years when she had recurrent episodes of syncope. Most of the syncopal episodes were exertional and started 3 years prior to the diagnosis. Her ECG at that time showed LV hypertrophy with T inversion in lateral chest leads (figure 1A) and echocardiographic examination showed severe LV hypertrophy with...
Source: Heart Asia - Category: Cardiology Authors: Tags: Postscript Source Type: research