Ventricular tachycardia and heart failure in a patient of mid‑ventricular obstructive hypertrophic cardiomyopathy with apical aneurysm: A case report

Abstract

Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC) with apical aneurysm is a rare type of cardiomyopathy. It is associated with an elevated risk of ventricular arrhythmias, thromboembolism, heart failure and sudden cardiac death. The present case study reports on a patient with MVOHC and apical aneurysm who developed ventricular arrhythmias and heart failure. The patient received an implantable cardioverter defibrillator for prevention of fatal arrhythmias. Ventricular tachycardia was terminated by increased doses of amiodarone and β-blocker. Transthoracic echocardiography indicated a mid-ventricular gradient of 64 mmHg. The patient refused surgical treatment and opted for alcohol septal ablation (ASA). At the 6-month follow-up, a rebound of the gradient following ASA was observed on echocardiography. In the present study, timely recognition of MVOHC with apical aneurysm led to prompt defibrillator implantation for prophylaxis regarding further malignant arrhythmias. Surgical management should be considered in symptomatic patients with MVOHC and apical aneurysm.

A portent of catastrophic carbon dioxide embolism in laparoscopic hepatectomy: A case report

“…[9] ETCO 2 monitoring is not very specific, and it may increase initially. [10] Moreover, the changes in ETCO 2 are rapid and sometimes of short duration; they could easily be missed in the operating theater. [11] Surgeons should be informed immediately and stop insufflation when there is clinical suspicion of CO 2 embolism.…”

Mid‐ventricular obstruction is associated with non‐sustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy

“…Due to the low‐prevalence rate of MVO in HCM patients, there is a paucity of information on the link between NSVT and MVO. Some case reports have shown that mid‐ventricular obstructive HCM with apical aneurysm usually presented with ventricular arrhythmia 6,7 9,18 .…”

“…HCM patients with mid‐ventricular obstruction (MVO), impedance to flow at the middle of the left ventricle, is a less common subtype of HCM but it is associated with ventricular arrhythmia and a worse prognosis 3‐5 . However, most studies concerning the relationship between HCM with MVO and ventricular arrhythmia were case reports or small series 6‐11 …”

Pacemaker Treatment for Apical Hypertrophic Cardiomyopathy in the Setting of an Apical Ventricular Aneurysm

“…The life-threating complications include fatal arrhythmias, such as ventricular tachycardia or ventricular fibrillation, and thromboembolic events. Regarding aggressive treatment strategies, ICD, radiofrequency catheter ablation, alcohol septal myocardial ablation, surgical myectomy, and aneurysmectomy have been proposed ( 1 , 2 , 3 , 4 ).…”