A 68-year-old female with severe hypertrophic obstructive cardiomyopathy experienced transient hypertension (165/105 mmHg) and myalgia four weeks after initiating mavacamten therapy.
Case Report (n=1)
No
Does mavacamten cause transient hypertension and myalgia in patients with severe HOCM?
Mavacamten therapy in HOCM may be associated with a previously unrecognized transient hypertensive phase and myalgia without CK elevation, warranting close blood pressure monitoring.
Background: Mavacamten has been demonstrated to be effective in the treatment of hypertrophic obstructive cardiomyopathy (HOCM). However, its hemodynamic impact and extracardiac effects require further characterization. Case presentation: We report a case of a 68-year-old female diagnosed with severe HOCM who experienced transient hypertension (165/105 mmHg) and myalgia four weeks after mavacamten initiation. Despite a significant reduction in LVOT obstruction (from 64 mmHg-18 mmHg) and an increase in LVEF to 78%, the patient exhibited a transient hypertensive response that resolved spontaneously within two weeks without intervention. Myalgia was present without corresponding elevations in serum creatine kinase. Conclusions: This case highlights a previously unrecognized transient hypertensive phase associated with myosin inhibition, potentially related to ventriculo-arterial decoupling and peripheral vascular adaptation. Additionally, the dissociation between myalgia and CK elevation suggests alternative skeletal muscle involvement mechanisms. Close blood pressure monitoring and further investigation into the extracardiac effects of mavacamten are warranted.
Peng 等人（Wed,）开展了一项关于肥厚型梗阻性心肌病的病例报告（n=1）。对 Mavacamten 进行了评估。一名患有严重肥厚型梗阻性心肌病的 68 岁女性在开始 mavacamten 治疗 4 周后出现了一过性高血压（165/105 mmHg）和肌痛。