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Myriad Cardiac Manifestation of Hyperhomocysteinemia
Jai Babu1, Prashanth Kumar Malkiwodeyar1, Shivashankara Tarikere1
1Department of Cardiology, SJICS&R, Bangalore, India.
Insights
High homocysteine levels are linked to cardiovascular issues. This case highlights a young stroke patient with dilated cardiomyopathy, who later developed unstable angina, left ventricular thrombus, and spontaneous coronary artery dissection.
Area of Science:
- Cardiology
- Vascular Medicine
- Neurology
Background:
- Elevated homocysteine is a known risk factor for arterial and venous thrombosis, dissection, and aneurysms.
- Hyperhomocysteinemia is associated with various cardiovascular diseases.
Observation:
- A young male patient presented with stroke, dilated cardiomyopathy, and left ventricular dysfunction.
- He subsequently developed unstable angina, left ventricular thrombus, and spontaneous coronary artery dissection.
Findings:
- The patient exhibited hyperhomocysteinemia, correlating with his cardiovascular events.
- Echocardiography revealed a left ventricular thrombus, and angiography showed spontaneous coronary artery dissection.
Implications:
- This case underscores the significant association between hyperhomocysteinemia and severe cardiovascular manifestations in young individuals.
- Optimal medical management can lead to asymptomatic outcomes in patients with these complex conditions.
Abstract:
Homocysteine has been recognized as a risk factor for various cardiovascular manifestations including thrombosis of arterial and venous system, spontaneous dissection involving various vessels in the body including coronaries and aneurysms. Here we report a young gentleman who was diagnosed as stroke in young and found to have dilated cardiomyopathy, with left ventricular dysfunction and hyperhomocysteinemia. Now the patient was presenting with unstable angina and found to have layered left ventricular thrombus on echocardiography and spontaneous coronary artery dissection on angiography. Our patient is being followed up on optimal medical management, as he is asymptomatic with medications.
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