HOCM DIAGNOSTIC DILEMMA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 15
Abstract
PRESENTATION OF CASE A 32 years old male, Type II diabetic patient was admitted in private nursing home in Mumbai in 2014 with h/o Chest Pain on exertion CCS class II, shortness of breath on exertion NYHA class II associated with intermittent palpitation since 2 months. Patient was comfortable at rest. There was no history of palpitations, syncope. His SpO2 was 98%, pulse 90/min, BP 116/70 in right upper limb. ECG showed Hyperacute T waves with ST elevation in all precordial leads. His CKMB, Tr T was in normal range. His Transthoracic 2D echocardiography showed mild concentric LVH, mild apical wall hypokinesia. Diagnosis of acute anterior wall myocardial infarction was made, and patient was thrombolysed with Reteplase. He was given Antiplatelets, statin and nitrates at the time of discharge. He was not prescribed beta blockers. Recently patient was evaluated at our center for similar symptoms. Clinically there was double apical impulse, systolic ejection murmur at neo aortic area. ECG had tall T waves with J point elevation. Echocardiography at our center showed HOCM with SAM and resting LVOT gradient of 30 mmHg. Diagnosis of HOCM confirmed by Cardiac MRI. Patients elder sister also died of cardiac illness at age of 38 years, but details of her illness not known to patient.
Authors and Affiliations
Avinash Yashwant Pawar
Keywords
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- EP ID EP555875
- DOI 10.18410/jebmh/2018/278
- Views 68
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