Alcohol drinking triggers acute myocardial infarction in a case of hypertrophic obstructive cardiomyopathy

Alcohol ingestion-related increased left ventricular outflow tract (LVOT) pressure gradient in hypertrophic obstructive cardiomyopathy (HOCM) has been reported in the literature; however, acute myocardial infarction (AMI) after alcohol drinking in this patient group is rarely reported. Herein, we report a 68-year-old man with chronic alcoholism suffering from AMI after alcohol drinking. Electrocardiography revealed complete left bundle branch block, and chest X-ray showed acute pulmonary edema. Intubation was done for respiratory failure and intra-aortic balloon pump was also inserted for unstable hemodynamics. However, emergent coronary angiography revealed normal coronary arteries. HOCM was diagnosed by a high pressure gradient over LVOT and systolic anterior motion of mitral valve by echocardiography. This patient became stable under intensive care and medical treatment. This case reminds physicians that alcohol ingestion might cause AMI in HOCM patients because of increased LVOT pressure gradient and decreased coronary perfusion despite normal coronary arteries.