Publication date: 2018

DOI: 10.1016/j.jacc.2018.03.426

Clinical Information Patient Initials or Identifier Number P Relevant Clinical History and Physical Exam 57 y.o. patient complaining of shortness of breath, fatigue, dizziness, moderate chest pain and heaviness in chest attended o the hospital in December 2016. Anamnesmorbi: HCM was diagnosed previously in 2013. During 2016 getting worse - syncope and lowered tolerance to physical exercise. Physical examination is remarkable for a paradoxical split of second heart sound and systolic ejection crescendo-decrescendo murmur. Relevant Test Results Prior to Catheterization TTE revealed: 1. Asymmetric HOCM with thickening of basal (19 mm) and middle (13.6 mm) interventricular septum. Peak systolic gradient at the LVOT was 96 mmHg at rest and 114 mmHg after 10 squats 2. I-II grade of mitral regurgitation. 3. Abnormal systolic anterior leaflet motion of the mitral valve. Relevant Catheterization Findings Coronarography revealed intact coronary arteries and two equipollent septal branches and LSX originating from RCA.

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Тип: Article