A 56-year-old man presented with breathlessness and chest pain. Echocardiography revealed 14-mm septal hypertrophy, complete systolic anterior motion of the anterior mitral valve leaflet, severe central mitral regurgitation, and a left ventricular outflow tract gradient of 40 mm Hg increasing to 56 mm Hg on Valsalva. A diagnosis of hypertrophic cardiomyopathy was made. Despite medical therapy, ...

At present, surgical septal myectomy is regarded as the "gold standard" treatment for most patients with obstructive hypertrophic cardiomyopathy (HCM) and drug-refractory symptoms. However, the best results are obtained by those surgeons who have extensive experience with this operation at a small number of referral centers. In the mid-1990s, percutaneous alcohol septal ablation was introduced ...

A proportion of patients with obstructive hypertrophic cardiomyopathy (HCM) and severe heart failure symptoms have only mild septal hypertrophy (1). In such patients, mitral valve (MV) abnormalities play an important role in systolic MV leaflets displacement into the left ventricular LV outflow tract and blood flow obstruction (1-3). Therefore, conventional septal myectomy alone may not be suff...

A patient with known obstructive hypertrophic cardiomyopathy developed worsening left ventricular outflow tract obstruction, severe mitral regurgitation, and apical ballooning leading to cardiogenic shock, a combination in which treatment of each component could worsen the others. Emergency veno-arterial extracorporeal membrane oxygenation, levosimendan, noradrenaline transiently restored adequ...

Mavacamten is a first-in-class cardiac myosin modulator for HOCM, which genetic disorder of the sarcomere. This study assessed cost effectiveness mavacamten in addition to standard care (SoC) compared with SoC alone, as well disopyramide, myectomy, and septal ablation each SoC. A semi-Markov model was used over lifetime time horizon from healthcare sector perspective cycle length 4 weeks. Patie...

Hypertrophic cardiomyopathy (HOCM) is characterized by asymmetric septal hypertrophy with outflow tract obstruction in approximately one-third of patients. However, recent studies suggest that obstruction may be present in up to 70% of patients with enhanced sympathetic activation under exercise conditions. Clinical features are dyspnoea on exertion, angina pectoris, and atrial and ventricular ...

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Recent meta-analyses have shown good long-term survival of patients with hypertrophic obstructive cardiomyopathy (HOCM) after alcohol septal ablation (ASA) comparable with surgical myectomy. However, gradient reduction after ASA was slightly less favourable [1, 2] and in a singlecentre study a higher rate of aborted sudden cardiac death was found [3]. The following case report illustrates the i...