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[Acute coronary syndrome without ST segment elevation in a patient with familial hypertrophic cardiomyopathy--a case

Joanna Kotlarska1, Agata Popielarz-Grygalewicz, Wojciech Drewniak

  • 1Kliniczny Oddział Kardiologii, Szpital Bielański, Warszawa.

Kardiologia Polska
|April 9, 2005
PubMed

Insights

This case study highlights acute coronary syndrome in a patient with hypertrophic cardiomyopathy. Successful angioplasty and stenting treated critical coronary artery stenosis, underscoring the need for careful diagnosis in these complex patients.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • Familial hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by left ventricular hypertrophy.
  • Patients with HCM are at increased risk for arrhythmias and sudden cardiac death.
  • Implantable cardioverter-defibrillators (ICDs) are often used for primary or secondary prevention of sudden cardiac death in HCM.

Observation:

  • A 46-year-old male with a history of HCM and ICD implantation presented with typical chest pain.
  • Previous coronary angiography showed normal coronary arteries, but current presentation revealed elevated Troponin I.
  • ECG showed paced QRS complexes and negative T waves, consistent with prior recordings.

Findings:

  • Coronary angiography identified critical stenosis in the left anterior descending coronary artery.
  • The patient underwent successful percutaneous coronary intervention (PCI) with stent implantation.
  • This case demonstrates acute coronary syndrome (ACS) in a patient with known HCM.

Implications:

  • HCM patients require careful consideration for non-arrhythmic cardiac events, such as ACS.
  • Diagnostic strategies for chest pain in HCM patients should include coronary angiography.
  • Management of ACS in HCM patients necessitates a multidisciplinary approach, considering both coronary and myocardial disease.

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