Why the study?
Does myotomy relieve angina in a patient with hypertrophic cardiomyopathy and a severe muscular bridge?
Does myotomy relieve angina in a patient with hypertrophic cardiomyopathy and a severe muscular bridge?
In young patients with hypertrophic cardiomyopathy and refractory angina, a coexisting muscular bridge should be considered and can be effectively treated with myotomy.
Myotomy may relieve angina in hypertrophic cardiomyopathy with muscular bridge; hypothesis-generating pending controlled trials.
We report the case of a 39-year-old male with hypertrophic cardiomyopathy who complained of angina pectoris. The patient was treated with a beta blocker and a calcium antagonist without effect. Myocardial scintigraphy revealed anterior ischemia. Cardiac catheterization and ventriculography revealed severe systolic narrowing of the left anterior descending coronary artery and no significant pressure gradient across the left ventricular outflow tract. Myotomy was performed on a muscular bridge over the left anterior descending coronary artery and the patient's angina was relieved. In young patients with hypertrophic cardiomyopathy who develop angina refractory to medical therapy, a coexisting muscular bridge should be sought.
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Topçuoğlu et al. (1998) studied this question.
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