CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

<p><strong>Objective of work:</strong> to describe the apical form of hypertrophic cardiomyopathy (AFHC) developing under the "mask" of the ischemic heart disease not diagnosed for a long period.</p><p><strong>Materials and methods.</strong> Patien...

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Main Authors: N. S. Krylova, A. Ye. Demkina, F. M. Khashiyeva, Ye. A. Kovalevskaya, N. G. Poteshkina, A. Ye. Vanyukov
Format: Article
Language:Russian
Published: ABV-press 2015-01-01
Series:Klinicist
Subjects:
Online Access:http://klinitsist.abvpress.ru/index.php/Klin/article/view/163
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author N. S. Krylova
A. Ye. Demkina
F. M. Khashiyeva
Ye. A. Kovalevskaya
N. G. Poteshkina
A. Ye. Vanyukov
author_facet N. S. Krylova
A. Ye. Demkina
F. M. Khashiyeva
Ye. A. Kovalevskaya
N. G. Poteshkina
A. Ye. Vanyukov
author_sort N. S. Krylova
collection DOAJ
description <p><strong>Objective of work:</strong> to describe the apical form of hypertrophic cardiomyopathy (AFHC) developing under the "mask" of the ischemic heart disease not diagnosed for a long period.</p><p><strong>Materials and methods.</strong> Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG), echocardiography (EchoCG), Holter ECG monitoring, coronary angiography (CAG), ventriculography.</p><p><strong>Results.</strong> The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV) hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6), EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg.), CAG (stenotic lesions of coronary arteries were found), ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicates<br />expressed apical hypertrophy of the LV myocard). AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.</p><p><strong>Conclusion</strong>. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.</p>
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spelling doaj.art-0f3dc5d2391c4de9b2da8325973b9c1e2023-01-02T11:10:05ZrusABV-pressKlinicist1818-83382015-01-01823944177CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINICN. S. Krylova0A. Ye. Demkina1F. M. Khashiyeva2Ye. A. Kovalevskaya3N. G. Poteshkina4A. Ye. Vanyukov5N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, 1 Ostrovityanova St., Moscow, 117997, RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, 1 Ostrovityanova St., Moscow, 117997, RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, 1 Ostrovityanova St., Moscow, 117997, RussiaCity Clinical Hospital Fifty Two, Moscow Healthсare Department, 3 Pekhotnaya St., Moscow, 123182, RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, 1 Ostrovityanova St., Moscow, 117997, RussiaCity Clinical Hospital Fifty Two, Moscow Healthсare Department, 3 Pekhotnaya St., Moscow, 123182, Russia<p><strong>Objective of work:</strong> to describe the apical form of hypertrophic cardiomyopathy (AFHC) developing under the "mask" of the ischemic heart disease not diagnosed for a long period.</p><p><strong>Materials and methods.</strong> Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG), echocardiography (EchoCG), Holter ECG monitoring, coronary angiography (CAG), ventriculography.</p><p><strong>Results.</strong> The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV) hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6), EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg.), CAG (stenotic lesions of coronary arteries were found), ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicates<br />expressed apical hypertrophy of the LV myocard). AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.</p><p><strong>Conclusion</strong>. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.</p>http://klinitsist.abvpress.ru/index.php/Klin/article/view/163hypertrophic cardiomyopathyischemic heart diseasemyocardial infarctionarterial hypertensionchronic heart failuretype 2 diabetes mellituselectrocardiography
spellingShingle N. S. Krylova
A. Ye. Demkina
F. M. Khashiyeva
Ye. A. Kovalevskaya
N. G. Poteshkina
A. Ye. Vanyukov
CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC
Klinicist
hypertrophic cardiomyopathy
ischemic heart disease
myocardial infarction
arterial hypertension
chronic heart failure
type 2 diabetes mellitus
electrocardiography
title CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC
title_full CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC
title_fullStr CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC
title_full_unstemmed CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC
title_short CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC
title_sort case of diagnosis of apical form of hypertrophic cardiomyopathy with a patient with progressive angina clinic
topic hypertrophic cardiomyopathy
ischemic heart disease
myocardial infarction
arterial hypertension
chronic heart failure
type 2 diabetes mellitus
electrocardiography
url http://klinitsist.abvpress.ru/index.php/Klin/article/view/163
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