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Polyarteritis nodosa and hypertrophic obstructive cardiomyopathy. A true association?
Dimitris P Papadopoulos1, Ioannis Moyssakis, Vassilios E Votteas
1Department of Cardiology, Laiko Hospital of Athens, Athens, Greece. jimpapdoc@yahoo.com
Clinical Rheumatology
|January 30, 2004
Summary
A patient with polyarteritis nodosa developed hypertrophic obstructive cardiomyopathy. This case highlights a potential, previously unreported association between these conditions.
Area of Science:
- Cardiology
- Rheumatology
- Systemic Vasculitis
Background:
- Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium-sized arteries.
- Cardiac manifestations in PAN are uncommon, typically involving pericarditis or myocardial infarction.
- Hypertrophic obstructive cardiomyopathy (HOCM) is a primary myocardial disease characterized by left ventricular outflow tract obstruction.
Observation:
- A 60-year-old male patient with known PAN presented with syncope.
- Diagnostic workup included echocardiography, coronary arteriography, and Holter monitoring.
- Echocardiography revealed findings consistent with HOCM.
Findings:
- Coronary arteriography showed normal coronary arteries, excluding ischemic causes.
- Holter monitoring detected episodes of non-sustained ventricular tachycardia.
- This represents the first documented case of HOCM developing in a patient with PAN.
Implications:
- The findings suggest a potential, albeit rare, association between PAN and HOCM.
- Further research is warranted to investigate the pathomechanisms and confirm this association.
- This case broadens the spectrum of cardiac complications associated with polyarteritis nodosa.