What is the clinical evidence from this study?

Study design: Case Report. Population: Hypertrophic cardiomyopathy (n=1). Intervention: sICD implantation and medical therapy (metoprolol and disopyramide).

What does this research mean for the field?

Cardiac magnetic resonance imaging provides critical prognostic information, such as the extent of fibrosis and edema, for risk stratification in young patients with massive hypertrophic cardiomyopathy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To describe the clinical presentation, multimodal diagnostic evaluation, and therapeutic management of extreme septal hypertrophic cardiomyopathy in a young patient.

September 15, 2026European Heart Journal Supplements

Hypertrophic Cardiomyopathy With Massive Septal Hypertrophy in a Young Patient: A Case Report

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Key result

sICD plus metoprolol and disopyramide reduces outflow gradient and resolves symptoms in massive septal hypertrophy.

Why the study?

Hypertrophic cardiomyopathy is the most common genetic cardiovascular disorder with an extremely variable clinical presentation, highlighting the need to explore presentation and prognostic assessment in massive forms.

Key Points

To describe the clinical presentation, multimodal diagnostic evaluation, and therapeutic management of extreme septal hypertrophic cardiomyopathy in a young patient.
A young patient presenting with acute chest pain, electrocardiographic alterations, and elevated troponin underwent diagnostic evaluation with transthoracic echocardiography and cardiac magnetic resonance imaging.
Inpatient telemetry monitoring, genetic screening for sarcomeric mutations, subcutaneous implantable cardioverter-defibrillator (sICD) implantation, and pharmacotherapy with metoprolol and disopyramide were completed.
Echocardiography revealed massive left ventricular septal hypertrophy measuring 44 mm with dynamic left ventricular outflow tract obstruction.
Cardiac MRI documented diffuse myocardial fibrosis via native T1 mapping, edema on T2 mapping, and extensive late gadolinium enhancement, while telemetry captured episodes of non-sustained ventricular tachycardia.
Genetic analysis detected pathogenic mutations in MYBPC3 and TNNT2, and follow-up after dual pharmacotherapy demonstrated progressive outflow gradient reduction and near-complete symptom resolution.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A young patient with no previous cardiac history presenting with chest pain, diagnosed with hypertrophic cardiomyopathy with massive septal hypertrophy.

Intervention

Implantation of a subcutaneous implantable cardioverter-defibrillator (sICD) for primary prevention, and medical therapy with metoprolol and disopyramide.

Outcome

Reduction of intraventricular outflow tract gradient and resolution of symptoms.surrogate

This case highlights the role of multimodality imaging, particularly cardiac magnetic resonance, in the prognostic assessment and management of massive hypertrophic cardiomyopathy.

Discussion

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Implication

Multimodal imaging may aid SCD risk stratification in extreme HCM; hypothesis-generating for dual sarcomeric mutations.

Cite This Study

Baù et al. (2026) conducted a case report in Hypertrophic cardiomyopathy (n=1). sICD implantation and medical therapy (metoprolol and disopyramide) was evaluated. In a young patient with massive septal hypertrophy, sICD implantation and medical therapy with metoprolol and disopyramide led to outflow tract gradient reduction and symptom resolution.

synapsesocial.com/papers/6aa9017deed42882c1fc1930 https://doi.org/10.1093/eurheartjsupp/suag058.227

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Hypertrophic Cardiomyopathy With Massive Septal Hypertrophy in a Young Patient: A Case Report

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Hypertrophic Cardiomyopathy With Massive Septal Hypertrophy in a Young Patient: A Case Report

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

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