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Apical hypertrophic cardiomyopathy: a case of slow flow in lad and malign ventricular arrhythmia

Emre Aksakal1, Oktay Yapici, Mustafa Yazici

  • 1Department of Cardiology, Ondokuz Mayis University, Medical Faculty, Samsun, Turkey.

The International Journal of Cardiovascular Imaging
|July 15, 2005
PubMed

Insights

This case study highlights a rare instance of slow coronary arterial flow in a 71-year-old male with apical hypertrophic cardiomyopathy. The patient experienced chest pain and sudden cardiac arrest, underscoring the potential severity of this condition.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Genetics

Background:

  • The coronary slow flow phenomenon (CSF) is an angiographic finding of delayed distal vessel opacification without significant epicardial coronary artery disease.
  • CSF is often associated with acute coronary syndromes, and histopathology reveals fibromuscular hyperplasia and myofibrillar hypertrophy.
  • Apical hypertrophic cardiomyopathy (AHC) is a progressive form of hypertrophic cardiomyopathy, typically asymptomatic until advanced stages, and rare in Western populations.

Observation:

  • A 71-year-old male presented with chest pain and sudden cardiac arrest.
  • The patient was diagnosed with apical hypertrophic cardiomyopathy.
  • The presentation was attributed to slow coronary arterial flow.

Findings:

  • This case demonstrates a rare association between apical hypertrophic cardiomyopathy and the coronary slow flow phenomenon.
  • The patient experienced life-threatening ventricular arrhythmia secondary to the cardiac condition.

Implications:

  • This case underscores the importance of considering CSF in patients with AHC presenting with ischemic symptoms or arrhythmias.
  • Early diagnosis and management of AHC and associated CSF may be crucial for preventing adverse cardiovascular events.
  • Further research into the pathophysiology linking AHC and CSF is warranted to improve patient outcomes.

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