Clinical significance of coronary artery disease in hypertrophic cardiomyopathy

Role of Perioperative Echocardiography in the Diagnosis of Hypertrophic Cardiomyopathy: Decoding Special Problem in the Background of Commoners

“…1 According to a study done in 1992 on American population, the incidence of significant CAD in patients with hypertrophic cardiomyopathy (HCM) was estimated to range from 7.6 to 19% in general but was as high as 24% in those over 45 years of age. 2 In a more recent study done in 2015, the prevalence of obstructive coronary stenosis was approximately 16% in HCM patients without typical chest pain. 3 Differentiating HCM from hypertensive heart disease is occasionally difficult.…”

“…Once general anesthesia was induced, transesophageal echocardiography (TEE) was performed and the above findings were confirmed. The TEE showed normal aortic valve with minimal thickening of leaflets with the valve area of 1.8 cm 2 in planimetry ( Fig. 2A) and severe eccentric mitral regurgitation (Fig.…”

A Case of Hypertrophic Cardiomyopathy Complicated by Acute Myocardial Infarction and Ventricular Tachycardia: Slow Coronary Artery Flow

“…Increased myocardial mass, intramyocardial small vessel disease, inadequate vasodilator reserve, septal perforator artery compression, coronary artery spasm, elevated filling pressures related to impaired diastolic relaxation and increased oxygen demand due to dynamic outflow gradients have all been suggested as the mechanisms of myocardial ischemia. 4) Yet three pathologic reports make intramural coronary artery disease the most likely mechanism that induces acute myocardial infarction in patients with HCM. McReynolds et al 5) found that 24 of 32 patients with HCM had abnormalities in the intramural coronary arteries, and this consisted of medial hypertrophy and cellular intimal proliferation.…”

Cardiomiopatia hipertrófica apical associada a doença arterial coronária

“…O encontro de angina do peito é comum nos pacientes mais idosos com este tipo de agressão 11 . A DAC esteve presente em 3,79% dos nossos pacientes com CMH 7 , sendo inferior ao referido por vários autores, que estimam sua freqüência entre 7,6 e 19%, elevada para, aproximadamente, 25% na faixa etária acima dos 45 anos [13][14][15][16][17] . Entre 48 casos de CMH necropsiados por Maron e col 18 , 15% apresentavam áreas de infarto do miocárdio sem comprometimento aterosclerótico, com espessamento da camada média e redução da luz dos pequenos vasos coronários intramiocárdicos, acreditando que, como esta alteração está presente em grande número de pacientes com CMH, ela possa decorrer de componente congênito no processo fundamental da cardiomiopatia.…”