Department of Cardiology & Vascular Medicine, Dr Soetomo General Hospital, Indonesia.
J Pak Med Assoc. 2024 Jun;74(6 (Supple-6)):S69-S72. doi: 10.47391/JPMA.S6-ACSA-13.
Symptoms of apical hypertrophic cardiomyopathy (ApHCM) can mimic acute myocardial infarction (AMI). Following COVID-19 infection, the elevation of troponin in ApHCM might be confusing, due to its similarity with AMI. We report the case of a 64-year-old male patient presenting with exertional dyspnoea and chest discomfort. He had no history of coronary artery disease (CAD), but his swab test was positive for COVID-19. The physical examination was normal. The 12-lead electrocardiogram showed a sinus rhythm of 78 bpm, with deep inverted T waves in leads V2 to V6, I, and aVL, and left ventricular hypertrophy. An Echocardiographic examination showed an 18 mm apical wall thickness of the left ventricle. Laboratory tests revealed elevated hs- Troponin level, but diagnostic coronary angiography was normal. The diagnostic criteria fulfilled apical cardiac hypertrophic cardiomyopathy. Coronavirus can induce atypical cardiovascular symptoms in pre-existing ApHCM. Misdiagnosis and failure to recognize may result in inappropriate therapy and delay in definitive treatment.
心尖肥厚型心肌病（ApHCM）的症状可能类似于急性心肌梗死（AMI）。在感染 COVID-19 后，ApHCM 中的肌钙蛋白升高可能会令人困惑，因为它与 AMI 相似。我们报告了一位 64 岁男性患者的病例，他表现为运动时呼吸困难和胸痛。他没有冠心病（CAD）病史，但咽拭子检测 COVID-19 呈阳性。体格检查正常。12 导联心电图显示窦性心率 78 次/分，V2 至 V6、I 和 aVL 导联的 T 波深度倒置，左心室肥厚。超声心动图检查显示左心室心尖壁厚度为 18 毫米。实验室检查显示高敏肌钙蛋白水平升高，但诊断性冠状动脉造影正常。诊断标准符合心尖型心肌肥厚型心肌病。冠状病毒可在原有 ApHCM 中引起非典型心血管症状。误诊和未识别可能导致不适当的治疗和延误明确治疗。
