A case report of refractory angina in a patient with diabetes and apical hypertrophic cardiomyopathy

BACKGROUND: Using serial imaging over time, this case reviews the natural history of co-morbid Type two diabetes (T2D) and apical hypertrophic cardiomyopathy (HCM) and assesses the potential combined impact on myocardial structure and perfusion. CASE SUMMARY: A 59-year-old patient with concomitant T...

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Detalles Bibliográficos
Autores principales: Jex, Nicholas, Chowdhary, Amrit, Thirunavukarasu, Sharmaine, Levelt, Eylem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9425848/
https://www.ncbi.nlm.nih.gov/pubmed/36045647
http://dx.doi.org/10.1093/ehjcr/ytac347
Descripción
Sumario:BACKGROUND: Using serial imaging over time, this case reviews the natural history of co-morbid Type two diabetes (T2D) and apical hypertrophic cardiomyopathy (HCM) and assesses the potential combined impact on myocardial structure and perfusion. CASE SUMMARY: A 59-year-old patient with concomitant T2D and an apical phenotype of HCM was seen over a 11-year period with a significant burden of anginal chest pain. Chest pain was refractory to anti-anginal medical therapy and persisted at on-going follow-up. Multi-modality imaging demonstrated significant deterioration in coronary microvascular function and increased myocardial scar burden despite unobstructed epicardial coronary arteries. DISCUSSION: Comorbidity with T2D and apical HCM resulted in a significant increase in myocardial fibrosis and deterioration in coronary microvascular function.

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