2021, Number 3
Cardiovasc Metab Sci 2021; 32 (3)
Hypertrophic obstructive cardiomyopathy in an octogenarian patient
Urzúa-González, Agustín Ramiro; Nieto-Saucedo, José Raúl; Muñiz-Castillo, Faviola; Rivera-Chávez, Manuel José; Preciado-Anaya, Andrés
ABSTRACT
Hypertrophic cardiomyopathy (HCM) is the most common inhered cardiac disease. Although clinical manifestations have been most commonly reported between the third and fifth decades of life, significant clinical symptoms can appear beyond the seventh decade of life, but this is less well appreciated. We present an 80-year-old female referred to our tertiary care center with the diagnosis of non-ST-elevation myocardial infarction. The invasive coronary angiography showed epicardial arteries with no significant lesions and the presence of left ventricular outflow tract obstruction, identified through the Brockenbrough-Braunwald-Morrow sign. In the past, HCM had been reserved as a relevant clinical entity in the young population because of its higher risk of sudden cardiac death, but its clinical behavior covers a broad spectrum of manifestations; currently, HCM is becoming more frequent to be diagnosed at advanced ages due to advances and accessibility of imaging modalities. Despite alcohol septal ablation and surgical myomectomy are the main therapeutic options for obstructive HCM, management of elderly HCM patients is still discussed. A multidisciplinary team must individually evaluate the case based on the clinical presentation, comorbidities, anatomical characteristics, and the hospital's expertise to decide the best therapeutic approach.