Abstract
A patient with hypertrophic obstructive cardiomyopathy (HOCM) was admitted with acute
heart failure. Echocardiography revealed significantly worsened left ventricular outflow
tract obstruction and pulmonary hypertension. Cardiac magnetic resonance imaging showed
biventricular dysfunction and, as an unexpected finding, a large embolus in the right
pulmonary artery. The patient gradually improved with medical therapy including oral
anticoagulation. In HOCM patients, pulmonary embolism may trigger heart failure due
to impaired left ventricular filling with consecutive outflow tract obstruction provocation.
Résumé
Un patient atteint de cardiomyopathie obstructive hypertrophique (COH) a été admis
pour insuffisance cardiaque aiguë. L'échocardiographie a révélé une aggravation significative
de l'obstruction de la voie d'éjection du ventricule gauche et une hypertension pulmonaire.
L'imagerie par résonance magnétique cardiaque a révélé une dysfonction biventriculaire
et, fait inattendu, un embole important dans l'artère pulmonaire droite. L'état du
patient s'est progressivement amélioré grâce à un traitement médical comprenant une
anticoagulation orale. Chez les patients atteints de COH, l'embolie pulmonaire peut
déclencher une insuffisance cardiaque due à une altération du remplissage du ventricule
gauche avec induction consécutive d'une obstruction de la voie d'éjection.
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References
- Hypertrophic obstructive cardiomyopathy.Lancet. 2017; 389: 1253-1267
- Venous thromboembolism in heart failure patients.J Am Coll Cardiol. 2020; 75: 159-162
- Incident heart failure and long-term risk for venous thromboembolism.J Am Coll Cardiol. 2020; 75: 148-158
Article info
Publication history
Published online: March 04, 2021
Accepted:
February 20,
2021
Received:
January 19,
2021
Footnotes
See page 1276 for disclosure information.
Identification
Copyright
© 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
