Percutaneous transluminal septal myocardial ablation in patients with hypertrophic cardiomyopathy may rarely exacerbate an underlying myocardial bridge, leading to typical angina.
PTSMA may rarely exacerbate myocardial bridges causing post-procedural angina in HCM; this case leaves open need for prospective study.
Background: Percutaneous transluminal septal myocardial ablation (PTSMA) is an effective means for symptomatic patients with hypertrophic cardiomyopathy (HCM). We present a rare case in which myocardial bridge (MB) was exacerbated in a patient with HCM treated with PTSMA. Case summary: Here, we present a case of HCM with palpitations and exertional dyspnoea for 2 years. There was no obvious epicardial coronary artery compression before PTSMA. Typical angina occurred 2 months after PTSMA. Coronary angiography showed no obvious stenosis of the coronary arteries, but an exacerbated MB in the middle part of the left anterior descending artery. Discussion: This patient with HCM presented with typical angina, which might be caused by the rare exacerbation of the MB after PTSMA. Thus, patients with MB should carefully choose PTSMA. Future research is needed for HCM patients complicated with MB treated with PTSMA.
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Wu et al. (2023) studied this question.
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