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Hypertrophic cardiomyopathy with a complex clinical course leading to heart transplantation

Uttam Savariya1, Maria M Patarroyo Aponte2, Sriram Nathan2

  • 1Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas.

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|January 3, 2022
PubMed

Insights

Two hypertrophic cardiomyopathy (HCM) patients with complex conditions, including arrhythmias and heart failure, successfully underwent heart transplantation (OHT). These cases demonstrate HCM

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Hypertrophic cardiomyopathy (HCM) can present with complex clinical courses.
  • Advanced medical management may be insufficient for severe HCM.
  • Surgical interventions like myectomy can be considered but may not always resolve symptoms.

Observation:

  • Two patients with HCM experienced severe ventricular arrhythmias and progressive heart failure.
  • One patient required orthotopic heart transplantation (OHT) due to refractory arrhythmias and heart failure.
  • A second patient underwent OHT after two myectomy procedures for persistent heart failure.

Findings:

  • Both patients experienced uneventful recovery following OHT.
  • Orthotopic heart transplantation served as a viable treatment option for end-stage HCM in these complex cases.
  • Clinicopathological features of these challenging HCM cases were presented.

Implications:

  • These cases underscore the diverse progression of hypertrophic cardiomyopathy.
  • Management of HCM requires addressing complex arrhythmias and heart failure.
  • Orthotopic heart transplantation is a critical option for select HCM patients with refractory disease.

Keywords:
HeartHeart failureHypertrophic cardiomyopathyTransplantationVentricular arrhythmia

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