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Published on: August 8, 2022
Extensive Calcification of the Ventricular Septum in Gene-Positive (MYBPC3) Nonobstructive Hypertrophic
Prabhjot Hundal1, Omar Nahhas1, M Fuad Jan2
1Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St Luke's Medical Centers, Milwaukee, Wisconsin, USA.
Insights
Extensive ventricular septal calcification, a rare finding after septal myectomy, was observed in a hypertrophic cardiomyopathy patient. This calcification may indicate severe myocardial fibrosis and requires comprehensive imaging evaluation.
Area of Science:
- Cardiology
- Medical Imaging
- Pathology
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease.
- Ventricular septal calcification is an uncommon finding.
- Postsurgical changes can lead to myocardial alterations.
Purpose of the Study:
- To present a case of extensive ventricular septal calcification.
- To explore the association between calcification and myocardial fibrosis.
- To highlight the diagnostic utility of multimodality imaging.
Main Methods:
- Multimodality imaging techniques were employed.
- Clinical data and patient history were reviewed.
- Histopathological correlation was considered.
Main Results:
- Extensive dystrophic calcification of the ventricular septum was identified.
- The calcification was hypothesized to be secondary to severe myocardial fibrosis.
- No prior reports of such findings post-septal myectomy exist.
Conclusions:
- Ventricular septal calcification is a rare finding, particularly after septal myectomy.
- This finding warrants thorough investigation and follow-up.
- Multimodality imaging is crucial for comprehensive evaluation.
Images:
We present multimodality imaging of ventricular septal calcification.
Case Summary:
A 38-year-old man with asymptomatic gene-positive hypertrophic cardiomyopathy was found to have extensive dystrophic calcification of the ventricular septum. We hypothesized that the extensive ventricular septal calcification would represent an area of severe myocardial fibrosis, resulting in calcification secondary to postsurgical (septal myectomy) changes.
Take-Home Message:
Calcification of the ventricular septum is a rare finding, not previously described following septal myectomy, that should prompt a comprehensive evaluation and follow-up with multimodality imaging and testing.
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Cardiomyopathy II: Dilated Cardiomyopathy
Cardiomyopathy IV: Restrictive Cardiomyopathy
Cardiomyopathy I: Introduction and Classification
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Heart Failure II: Pathophysiology

