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February 27, 2026JACC Case Reports0 citationsOpen Access

Paradoxical Pulmonary Congestion After Mavacamten in Obstructive HCM

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NTNoriaki TabataYIYasuhiro IzumiyaNNNoriko Nomura

Key Points

  • To investigate the phenomenon of paradoxical pulmonary congestion after treatment with mavacamten in obstructive hypertrophic cardiomyopathy (HCM).
  • Conducted a noninvasive hemodynamic assessment during early treatment phases.
  • Monitored changes in pulmonary congestion following LVOT obstruction relief.
  • Identified instances of paradoxical pulmonary congestion despite relief of LVOT obstruction.
  • Emphasized the need for comprehensive monitoring during treatment initiation.

Abstract

Relief of LVOT obstruction can be associated with paradoxical pulmonary congestion despite apparent left-sided unloading. This observation highlights the importance of comprehensive noninvasive hemodynamic assessment during the early treatment phases of obstructive HCM.

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Tabata et al. (2026) studied this question.

synapsesocial.com/papers/69a1344fed1d949a99abe15fhttps://doi.org/10.1016/j.jaccas.2026.107025
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