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Pregnancy in Hypertrophic Cardiomyopathy with Severe Left Ventricular Outflow Tract Obstruction

Jaeouk Shin1, Minsu Kim1, Junsoo Lee1

  • 1Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea.; Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea.

Journal of Cardiovascular Ultrasound
|July 1, 2016
PubMed

Insights

Pregnant patients with severe hypertrophic obstructive cardiomyopathy (HOCM) face high risks. Close monitoring and management are crucial for successful delivery in these high-risk HOCM pregnancies.

Area of Science:

  • Cardiology
  • Obstetrics
  • Maternal-Fetal Medicine

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) poses significant risks during pregnancy, particularly severe left ventricular outflow tract (LVOT) obstruction (>100 mm Hg).
  • Pregnancy-induced physiological changes can exacerbate HOCM, leading to serious maternal and fetal complications like sudden cardiac death, heart failure, and arrhythmias.

Observation:

  • A 27-year-old pregnant patient at 34 weeks gestation presented with severe HOCM and a resting LVOT pressure gradient (PG) of 125 mm Hg, increasing to 152 mm Hg with Valsalva maneuver.
  • This case highlights the critical need for vigilant monitoring and tailored management strategies in pregnant individuals with extremely high LVOT obstruction.

Findings:

  • Close echocardiographic monitoring and appropriate medical management facilitated a successful delivery.
  • The case demonstrates that even with extremely high pressure gradients, favorable maternal and fetal outcomes are achievable.

Implications:

  • This case underscores the importance of multidisciplinary care for pregnant patients with severe HOCM.
  • Effective management strategies can mitigate risks and improve outcomes for both mother and fetus in high-risk pregnancies involving HOCM.

Keywords:
EchocardiographyHigh risk pregnancyHypertrophic cardiomyopathyLeft ventricular outflow obstruction

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