47 years old male smoker with no co morbidities, presented with history of chest pain in the retrosternal area for the 3 days. The Pain was described as sharp, non-exertional and intermittent. Patient did not have any family history of known cardiac disease or sudden cardiac death. A Clinical examination failed to reveal any abnormalities. An ECG revealed deep T wave inversion in the anterolateral chest leads with left ventricular hypertrophy (LVH). Bloods analysis showed normal Complete blood count, liver function and mildly increased cardiac troponins. The Patient was admitted to the CoronaryCare Unit with a diagnosis of acute coronary syndrome. Patient was initiated dual antiplatelets, fondaparinux and high intensity atorvastatin. Following this, an echocardiogram revealed severe Left ventricular hypertrophy and reduced LV (left ventricular) cavity dimensions. Good LV systolic function with grade 3 diastolic dysfunction was noted. Coronary angiogram showed a normal right and left coronary system. Patient was diagnosed with hypertrophic cardiomyopathy. Cardiac MRI Showed severe Left ventricular hypertrophy with interventricular septum thickness 3.7 cm with rest of the walls hypertrophied. There was evidence of severe fibrosis of the septum, anterior and lateral wall. On the basis of severe left ventricular hypertrophy (especially septal thickness >3.5 cm) and myocardial fibrosis, Patient was started on beta blockers and ICD was inserted for primary prevention of arrhythmias.
| Published in | Cardiology and Cardiovascular Research (Volume 4, Issue 1) |
| DOI | 10.11648/j.ccr.20200401.15 |
| Page(s) | 22-26 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Hypertrophic Cardiomyopathy, Acute Coronary Syndrome, Myocardial Fibrosis
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| [7] | McLeod CJ, Ackerman MJ, Nishimura RA, et all. Outcome of patients with hypertrophic cardiomyopathy and a normal electrocardiogram. J AM Coll Cardiolo. 2009; 54: 229. |
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| [13] | Adabag AS, Maron BJ, Appelbaum E, et al. Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy in relation to delayed enhancement on cardiovascular magnetic resonance. J Am Coll Cardiol. 2008; 51: 1369–1374. |
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APA Style
Ambreen Gul, Ali Gohar Lodro. (2020). Acute Coronary Syndrome and Myocardial Ischemia in Hypertrophic Cardiomyopathy. Cardiology and Cardiovascular Research, 4(1), 22-26. https://doi.org/10.11648/j.ccr.20200401.15
ACS Style
Ambreen Gul; Ali Gohar Lodro. Acute Coronary Syndrome and Myocardial Ischemia in Hypertrophic Cardiomyopathy. Cardiol. Cardiovasc. Res. 2020, 4(1), 22-26. doi: 10.11648/j.ccr.20200401.15
AMA Style
Ambreen Gul, Ali Gohar Lodro. Acute Coronary Syndrome and Myocardial Ischemia in Hypertrophic Cardiomyopathy. Cardiol Cardiovasc Res. 2020;4(1):22-26. doi: 10.11648/j.ccr.20200401.15
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Download@article{10.11648/j.ccr.20200401.15,
author = {Ambreen Gul and Ali Gohar Lodro},
title = {Acute Coronary Syndrome and Myocardial Ischemia in Hypertrophic Cardiomyopathy},
journal = {Cardiology and Cardiovascular Research},
volume = {4},
number = {1},
pages = {22-26},
doi = {10.11648/j.ccr.20200401.15},
url = {https://doi.org/10.11648/j.ccr.20200401.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200401.15},
abstract = {47 years old male smoker with no co morbidities, presented with history of chest pain in the retrosternal area for the 3 days. The Pain was described as sharp, non-exertional and intermittent. Patient did not have any family history of known cardiac disease or sudden cardiac death. A Clinical examination failed to reveal any abnormalities. An ECG revealed deep T wave inversion in the anterolateral chest leads with left ventricular hypertrophy (LVH). Bloods analysis showed normal Complete blood count, liver function and mildly increased cardiac troponins. The Patient was admitted to the CoronaryCare Unit with a diagnosis of acute coronary syndrome. Patient was initiated dual antiplatelets, fondaparinux and high intensity atorvastatin. Following this, an echocardiogram revealed severe Left ventricular hypertrophy and reduced LV (left ventricular) cavity dimensions. Good LV systolic function with grade 3 diastolic dysfunction was noted. Coronary angiogram showed a normal right and left coronary system. Patient was diagnosed with hypertrophic cardiomyopathy. Cardiac MRI Showed severe Left ventricular hypertrophy with interventricular septum thickness 3.7 cm with rest of the walls hypertrophied. There was evidence of severe fibrosis of the septum, anterior and lateral wall. On the basis of severe left ventricular hypertrophy (especially septal thickness >3.5 cm) and myocardial fibrosis, Patient was started on beta blockers and ICD was inserted for primary prevention of arrhythmias.},
year = {2020}
}
TY - JOUR T1 - Acute Coronary Syndrome and Myocardial Ischemia in Hypertrophic Cardiomyopathy AU - Ambreen Gul AU - Ali Gohar Lodro Y1 - 2020/03/18 PY - 2020 N1 - https://doi.org/10.11648/j.ccr.20200401.15 DO - 10.11648/j.ccr.20200401.15 T2 - Cardiology and Cardiovascular Research JF - Cardiology and Cardiovascular Research JO - Cardiology and Cardiovascular Research SP - 22 EP - 26 PB - Science Publishing Group SN - 2578-8914 UR - https://doi.org/10.11648/j.ccr.20200401.15 AB - 47 years old male smoker with no co morbidities, presented with history of chest pain in the retrosternal area for the 3 days. The Pain was described as sharp, non-exertional and intermittent. Patient did not have any family history of known cardiac disease or sudden cardiac death. A Clinical examination failed to reveal any abnormalities. An ECG revealed deep T wave inversion in the anterolateral chest leads with left ventricular hypertrophy (LVH). Bloods analysis showed normal Complete blood count, liver function and mildly increased cardiac troponins. The Patient was admitted to the CoronaryCare Unit with a diagnosis of acute coronary syndrome. Patient was initiated dual antiplatelets, fondaparinux and high intensity atorvastatin. Following this, an echocardiogram revealed severe Left ventricular hypertrophy and reduced LV (left ventricular) cavity dimensions. Good LV systolic function with grade 3 diastolic dysfunction was noted. Coronary angiogram showed a normal right and left coronary system. Patient was diagnosed with hypertrophic cardiomyopathy. Cardiac MRI Showed severe Left ventricular hypertrophy with interventricular septum thickness 3.7 cm with rest of the walls hypertrophied. There was evidence of severe fibrosis of the septum, anterior and lateral wall. On the basis of severe left ventricular hypertrophy (especially septal thickness >3.5 cm) and myocardial fibrosis, Patient was started on beta blockers and ICD was inserted for primary prevention of arrhythmias. VL - 4 IS - 1 ER -
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