Key result
A 71-year-old woman with hypertrophic cardiomyopathy and prior alcohol septal ablation presented with dyspnea caused by multiple factors requiring extensive surgical intervention.
Why the study?
Residual or recurrent symptoms following septal reduction therapy are typically attributed to inadequate relief of left ventricular outflow gradients, but alternative etiologies may occur.
Case Report (n=1)
Highlights a complex case of recurrent dyspnea after septal ablation due to multiple concurrent cardiac and vascular pathologies requiring extensive surgical intervention.
Multiple concurrent pathologies may underlie post-ablation dyspnea in HCM; extends differential but remains hypothesis-generating for management.
Residual or recurrent symptoms after septal reduction therapy are most often related to inadequate relief of left ventricular outflow gradients. We recently encountered a 71-year-old woman with hypertrophic cardiomyopathy and prior alcohol septal ablation who had a unique constellation of findings causing her symptoms. She was found to have four potential causes for her symptoms, residual midventricular obstruction, apical distribution of hypertrophy reducing end-diastolic volume, constrictive pericarditis, and marked arterial stiffness, as reflected by aortic atherosclerosis. She underwent complete pericardiectomy, transaortic septal myectomy, transapical myectomy, and replacement of a heavily calcified ascending aorta.
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Ghoniem et al. (2020) conducted a case report in Hypertrophic cardiomyopathy with prior alcohol septal ablation and dyspnea (n=1). Complete pericardiectomy, transaortic septal myectomy, transapical myectomy, and replacement of ascending aorta was evaluated. A 71-year-old woman with hypertrophic cardiomyopathy and prior alcohol septal ablation presented with dyspnea caused by multiple factors requiring extensive surgical intervention.
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