Belmonte Emanuela, Arcari Luca, Camastra Giovanni, Ciolina Federica, Danti Massimiliano, Sbarbati Stefano, Musarò Salvatore Donato, Cacciotti Luca
Cardiology Unit, Madre Giuseppina Vannini Hospital, Rome, Italy.
Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy.
Heliyon. 2024 Oct 19;10(20):e38919. doi: 10.1016/j.heliyon.2024.e38919. eCollection 2024 Oct 30.
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disorder, more often presenting with asymmetrical septal hypertrophy. Here we report the case of a patient, affected by arterial hypertension, presenting to the emergency department with chest pain, electrocardiographic changes and troponin rise. Further diagnostic work-up ruled out ischemic heart disease and lead to the diagnosis of a rare HCM phenotype affecting the lateral wall of the left ventricle. Cardiac magnetic resonance imaging proved to be a reliable diagnostic test in this case thanks to its tissue characterization ability, allowing the identification of diffuse fibrosis through native T1 mapping, edema through T2 mapping and replacement fibrosis with late gadolinium enhancement, providing us with robust diagnostic and prognostic information. The association of arterial hypertension with atypical HCM forms emerged from multicentric studies, however, further research is needed to fully clarify the complex interactions between arterial hypertension and phenotypic expression of HCM.
肥厚型心肌病(HCM)是最常见的遗传性心血管疾病,更常表现为不对称性室间隔肥厚。在此,我们报告一例患有动脉高血压的患者,因胸痛、心电图改变和肌钙蛋白升高就诊于急诊科。进一步的诊断检查排除了缺血性心脏病,并确诊为一种罕见的影响左心室侧壁的HCM表型。心脏磁共振成像在该病例中被证明是一种可靠的诊断检查,这得益于其组织特征分析能力,通过原生T1映射可识别弥漫性纤维化,通过T2映射可识别水肿,通过延迟钆增强可识别替代性纤维化,为我们提供了有力的诊断和预后信息。多中心研究发现了动脉高血压与非典型HCM形式之间的关联,然而,需要进一步研究以充分阐明动脉高血压与HCM表型表达之间的复杂相互作用。