Kawamata Hirofumi, Kawasaki Tatsuya, Kamitani Tadaaki, Yoshioka Keiji, Matoba Satoaki, Sugihara Hiroki
Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
J Electrocardiol. 2018 Sep-Oct;51(5):895-897. doi: 10.1016/j.jelectrocard.2018.06.014. Epub 2018 Jun 26.
Hypertrophic cardiomyopathy (HCM) patients sometimes develop subendocardial ischemia without coronary artery stenosis. We report a case of non-obstructive HCM, in which electrocardiographic changes were observed with improvement of subendocardial ischemia. A 76-year-old man presented with chest pain on exertion. The electrocardiogram revealed left ventricular (LV) hypertrophy with repolarization abnormalities. No coronary stenosis was found on computed tomography angiography, but thallium-201 exercise scintigraphy revealed transient LV cavity dilation after exercise, consistent with subendocardial ischemia. His chest symptoms disappeared after starting verapamil. Transient LV cavity dilation improved without a reduction in exercise tolerance, as did electrocardiographic abnormalities without any changes on echocardiography.
