Key result
A 60-year-old man with hypertrophic cardiomyopathy presented in cardiogenic shock with a vanishing LVOT gradient that returned upon recovery of left ventricular function.
Case Report (n=1)
Demonstrates that LVOT gradients in hypertrophic cardiomyopathy can temporarily vanish during cardiogenic shock due to acute hemodynamic collapse and return upon recovery of left ventricular function.
Supports cautious LVOT gradient interpretation in HCM shock; leaves open optimal assessment timing during recovery.
Cardiogenic shock is well described in hypertrophic cardiomyopathy (HCM) as acute hemodynamic collapse can develop in the setting of acute worsening of left ventricular outflow tract (LVOT) obstruction. We present the case of a 60-year-old man with drug refractory LVOT obstruction due to hypertrophic cardiomyopathy. On the evening prior to planned alcohol septal ablation, the patient presented in cardiogenic shock. Interestingly, his previously recorded LVOT gradients of 50 mm Hg at rest and 118 mm Hg at peak exercise were absent. With recovery of left ventricular function, significant left ventricular outflow obstruction returned. The patient then underwent successful septal reduction therapy.
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Corrigan et al. (2016) conducted a case report in Hypertrophic cardiomyopathy with cardiogenic shock (n=1). Septal reduction therapy was evaluated. A 60-year-old man with hypertrophic cardiomyopathy presented in cardiogenic shock with a vanishing LVOT gradient that returned upon recovery of left ventricular function.
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