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Managing Stroke Prevention in Hypertrophic Obstructive Cardiomyopathy (HOCM) Patients Without Confirmed Persistent

Christine Henen1, Elise A Johnson2, Sergio Sokol3

  • 1Internal Medicine, St. John's Episcopal Hospital, Far Rockaway, USA.

Cureus
|October 11, 2023
PubMed

Insights

Hypertrophic obstructive cardiomyopathy (HOCM) increases stroke risk, often due to atrial fibrillation (AFib). This case study examines stroke prevention in HOCM patients without confirmed AFib, questioning the need for anticoagulation.

Area of Science:

  • Cardiology
  • Neurology
  • Genetics

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic heart condition causing left ventricular thickening.
  • It is a primary cause of sudden cardiac death in young adults.
  • HOCM patients face elevated risks of arrhythmias and stroke.

Observation:

  • Atrial fibrillation (AFib), a common HOCM complication, elevates stroke risk by promoting clot formation.
  • Uncertainty exists regarding stroke prevention for HOCM patients without persistent AFib.
  • This case study focuses on managing recurrent cerebrovascular events (CVA) in an HOCM patient lacking confirmed persistent AFib.

Findings:

  • The central debate involves the necessity of anticoagulation for secondary stroke prevention in HOCM patients.
  • This includes evaluating risks and benefits in the absence of a definitive AFib diagnosis.

Implications:

  • Findings may guide clinical decisions on anticoagulation strategies for HOCM patients.
  • This research could refine secondary stroke prevention protocols in this specific patient population.
  • Understanding stroke mechanisms in HOCM without AFib is crucial for patient management.

Keywords:
atrial fibrillation (af)hypertrophic obstructive cardiomyopathy (hocm)paroxysmal afibpersistent atrial fibrillationstroke

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