Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Kunming, Yunnan Province, China.
Medicine (Baltimore). 2023 May 19;102(20):e33752. doi: 10.1097/MD.0000000000033752.
We report a rare case of hypertrophic cardiomyopathy (HCM) caused by a heterozygous variant in TTR gene.
The proband had been vomiting without obvious inducement since the age of 27, accompanied by the expulsion of stomach contents. At the age of 28, she began to suddenly syncope.
Cardiac magnetic resonance showed thickening of the right ventricular lateral wall and ventricular septum. The left ventricular diastolic function was limited. Targeted Sanger sequencing validates the presence of mutation p.Leu75Pro in TTR gene.
After admission to hospital for syncope, she was given metoprolol tablets 25 mg bid, spironolactone tablets 20 mg qd, and trimetazidine 20 mg tid. Her symptoms improved after taking the medicine.
The results of this case show that HCM caused by TTR mutation is not easy to be identified and treatment is easy to be delayed. Therefore, high-risk patients with amyloidosis should be evaluated as soon as possible. Timely diagnosis of HCM caused by TTR mutation before irreversible organ damage is essential for proper treatment and better outcomes.
我们报告了一例由 TTR 基因突变引起的罕见肥厚型心肌病(HCM)病例。
患者自 27 岁开始出现无明显诱因的呕吐,伴有胃内容物排出。28 岁时,她开始突然晕厥。
心脏磁共振显示右心室侧壁和室间隔增厚。左心室舒张功能受限。靶向 Sanger 测序证实 TTR 基因存在突变 p.Leu75Pro。
晕厥入院后,给予美托洛尔片 25mg,bid;螺内酯片 20mg,qd;曲美他嗪 20mg,tid。服药后症状改善。
该病例结果表明,TTR 突变引起的 HCM 不易被识别,治疗容易被延误。因此,应尽快评估淀粉样变的高危患者。在不可逆的器官损伤之前,及时诊断 TTR 突变引起的 HCM 对于适当的治疗和更好的预后至关重要。