What is the clinical evidence from this study?

Study design: Case Report. Population: Hypertrophic cardiomyopathy (n=1). Intervention: Subcutaneous implantable cardioverter-defibrillator and close monitoring.

What question did this study set out to answer?

To describe the risk stratification, genetic evaluation, and multidisciplinary clinical management of severe obstructive hypertrophic cardiomyopathy during pregnancy.

September 15, 2026European Heart Journal Supplements

A High–risk Pregnancy in Hypertrophic Cardiomyopathy: A Case Report Highlighting Intrafamilial Phenotypic Variability and Management Challenges

Q: What does this research mean for the field?

Individualized management strategies, including early risk assessment and multidisciplinary care, can enable successful pregnancy outcomes in women with severe obstructive hypertrophic cardiomyopathy despite significant intrafamilial phenotypic variability. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

S-ICD and close monitoring safely manage severe obstructive HCM during pregnancy to term delivery.

Why the study?

Pregnancy in women with obstructive HCM represents a high-risk condition with limited pharmacological options, posing challenges for risk stratification and management.

Population

One 24-year-old pregnant woman with obstructive HCM and a pathogenic MYH7 variant

Design

Case report

Authors

FOF OnoratoPoliclinico Tor Vergata CLC LanzilloPoliclinico Tor Vergata

Discussion

Member takes

Implication

May support multidisciplinary monitoring and timely ICD use in select pregnant obstructive HCM patients; leaves open need for prospective data.

Key Points

To describe the risk stratification, genetic evaluation, and multidisciplinary clinical management of severe obstructive hypertrophic cardiomyopathy during pregnancy.
Evaluated a 24-year-old pregnant woman (N=1) at three months gestation presenting with NYHA class III dyspnea and a family history of hypertrophic cardiomyopathy.
Performed genetic sequencing of the MYH7 gene, maternal echocardiographic hemodynamic assessment, and sudden cardiac death risk stratification.
Echocardiography revealed severe septal hypertrophy (25 mm) and severe left ventricular outflow tract obstruction with a peak gradient >150 mmHg alongside an estimated sudden cardiac death risk of 6.62%.
A subcutaneous implantable cardioverter-defibrillator was successfully placed during pregnancy, enabling full-term delivery via elective cesarean section without major maternal complications.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 24-year-old pregnant woman with obstructive hypertrophic cardiomyopathy and severe LVOT obstruction managed with a subcutaneous ICD.

Intervention

Close outpatient monitoring, subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation during pregnancy, elective cesarean section, and postpartum optimization of medical therapy.

Outcome

Maternal and fetal outcomes (pregnancy completion, delivery method, and postpartum symptomatic status).

Multidisciplinary care and individualized management, including S-ICD implantation, can lead to successful pregnancy outcomes in high-risk patients with severe obstructive HCM.

Cite This Study

Onorato et al. (2026) conducted a case report in Hypertrophic cardiomyopathy (n=1). Subcutaneous implantable cardioverter-defibrillator and close monitoring was evaluated. A 24-year-old pregnant woman with severe obstructive hypertrophic cardiomyopathy was successfully managed with a subcutaneous ICD and close monitoring, delivering at term without major complications.

synapsesocial.com/papers/6aa9017deed42882c1fc193b https://doi.org/10.1093/eurheartjsupp/suag058.043

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Implication

May support multidisciplinary monitoring and timely ICD use in select pregnant obstructive HCM patients; leaves open need for prospective data.

A High–risk Pregnancy in Hypertrophic Cardiomyopathy: A Case Report Highlighting Intrafamilial Phenotypic Variability and Management Challenges

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

A High–risk Pregnancy in Hypertrophic Cardiomyopathy: A Case Report Highlighting Intrafamilial Phenotypic Variability and Management Challenges

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider