Echocardiography – the elective imagistic method used in the assessment of patients with obstructive hypertrophic cardiomyopathy

Introduction: We are presenting the case of a patient with obstructive hypertrophic cardiomyopathy from the casuistic of The Institute of Cardiovascular Diseases in Timișoara – 37 patients diagnosed with obstructive hypertrophic cardiomyopathy admitted between 2003 and 2013. Methods: The patient, female, 66 years of age, with cardiovascular risk factors (age, diabetes mellitus, dyslipidemia), was diagnosed a year ago with obstructive hypertrophic cardiomyopathy, but did not have optimal ambulatory treatment and presented in our clinic with worsening of the cardiac insufficiency symptoms. Results: The electrocardiogram and transthoracic echocardiography showed the diagnostic signs of obstructive hypertrophic cardiomyopathy with moderate obstruction in the ejection path of the left ventricle (47 mm Hg) and mild mitral regurgitation. Contrast echo cardiography allowed the evaluation of the left ventricle and excluded an apical form of hypertrophic cardiomyopathy. Stress-echocardiography (on the ergometric bicycle) showed the growth of the obstruction in the path of the left ventricle at a maximum gradient of 90 mm Hg, without the worsening of the mitral regurgitation. The coronary angiography showed permeable coronary and septal arteries with an anatomy that allows alcohol ablation. Conclusions: And so, by utilizing more echocardiographic techniques, we made a complete diagnosis and we properly evaluated the severity of the obstructive hypertrophic cardiomyopathy, leaving the follow-ups and the future course of treatment to be established also by echocardiographic exam.

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