P358 FATAL CONSPIRACY: MIDVENTRICULAR OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY COMPLICATED BY GIANT APICAL ANEURYSM AND SEVERE MITRAL REGURGITATION

نویسندگان

چکیده

Abstract This case refers to a 69–year–old woman with history of hypertrophic cardiomyopathy (HCM) severe mid–ventricular obstruction complicated by apical aneurysm and restrictive phenotype. patient had no left ventricular outflow tract previous examinations showed moderate mitral regurgitation (MR) suboptimal echocardiographic follow–up. ICD was previously implanted for primary prevention. Disease progression episodes acute heart failure (HF) caused atrial fibrillation/tachycardia (AF or AT) rapid response despite pharmacological therapy transcatheter ablation attempt. The admitted our Cardiac Intensive Care Unit pulmonary oedema extreme general frailty. EKG normal sinus rhythm alternating AT high rate. Transthoracic (TTE) transesophageal (TEE) echocardiograms gave evidence hypertrophy (LV) mid–cavity segments (mid IVS = 26 mm) systolic obliteration (with more significant gradient) large (37x35 resulting in an “hourglass” shaped LV cavity (Figure 1). In addition the highlighted dysfunction stroke volume reduction MR annulus dilatation anterior jet direction due leaflets abnormal coaptation 2). HF multifactorial, not only tachyarrhythmias but also small chamber low compliance. anatomical features obtained from TEE cardiac CT 3) were analyzed Heart Team. Surgery aneurysmectomy valve repair replacement excluded patient‘s Despite anatomy, percutaneous MitraClip considered deferred owing unstable hemodynamic conditions. Further deterioration led patient’s exitus. Discussion HCM may be aneurysm. Large aneurysms can reduce contractile efficiency combination cause further loss anterograde output leading progressive fatal deterioration. A better outcome achieved through careful follow–up early detection management disease complications.

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ژورنال

عنوان ژورنال: European Heart Journal Supplements

سال: 2023

ISSN: ['1520-765X', '1554-2815']

DOI: https://doi.org/10.1093/eurheartjsupp/suad111.431