Why the study?
Mid-ventricular obstructive hypertrophic cardiomyopathy with apical aneurysm is a rare cardiomyopathy associated with elevated risks of ventricular arrhythmias, thromboembolism, heart failure, and sudden cardiac death.
Timely recognition of MVOHC with apical aneurysm is crucial for prompt ICD implantation, and surgical management should be considered over alcohol septal ablation in symptomatic patients.
Reinforces arrhythmic and HF risk in MVOHC with apical aneurysm; leaves open optimal ICD timing and risk stratification.
Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC) with apical aneurysm is a rare type of cardiomyopathy. It is associated with an elevated risk of ventricular arrhythmias, thromboembolism, heart failure and sudden cardiac death. The present case study reports on a patient with MVOHC and apical aneurysm who developed ventricular arrhythmias and heart failure. The patient received an implantable cardioverter defibrillator for prevention of fatal arrhythmias. Ventricular tachycardia was terminated by increased doses of amiodarone and β-blocker. Transthoracic echocardiography indicated a mid-ventricular gradient of 64 mmHg. The patient refused surgical treatment and opted for alcohol septal ablation (ASA). At the 6-month follow-up, a rebound of the gradient following ASA was observed on echocardiography. In the present study, timely recognition of MVOHC with apical aneurysm led to prompt defibrillator implantation for prophylaxis regarding further malignant arrhythmias. Surgical management should be considered in symptomatic patients with MVOHC and apical aneurysm.
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Zhang et al. (2019) studied this question.
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