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Hypertrophic Cardiomyopathy with Biventricular Involvement and Coronary Anomaly: A Case Report

Ylenia Bartolacelli1, Simone Bonetti1, Anna Balducci1

  • 1Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40122 Bologna, Italy.

Life (Basel, Switzerland)
|October 27, 2022
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) can affect both ventricles, causing right ventricular (RV) outflow obstruction. Surgical relief of this obstruction improved symptoms and reduced gradients in a patient with biventricular HCM.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) is typically a left ventricular disease.
  • Right ventricular (RV) involvement in HCM is less understood.
  • Biventricular HCM presents unique diagnostic and therapeutic challenges.

Observation:

  • A case of biventricular HCM with significant RV hypertrophy and outflow tract obstruction was observed.
  • The patient presented with near obliteration of the RV cavity and no left intraventricular gradient.
  • Symptoms included potential for heart failure, arrhythmias, and pulmonary thromboembolism due to RV dysfunction.

Findings:

  • Surgical intervention successfully eliminated the RV outflow tract obstruction.
  • The patient experienced improved symptoms and a significant reduction in postoperative gradients.
  • Direct relief of RV outflow obstruction demonstrated low morbidity and favorable intermediate- to long-term outcomes.

Implications:

  • Significant RV hypertrophy in HCM can lead to severe outflow obstruction and diastolic dysfunction.
  • Conventional surgery is a viable option for relieving RV outflow obstruction in HCM.
  • Effective treatment of RV obstruction can lead to significant symptomatic improvement in biventricular HCM patients.

Keywords:
cardiac imaginghypertrophic cardiomyopathyright ventricular obstruction

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