Hypertronic cardiomyopathy with midventricular obstruction associated with coronary artery disease ( A case report )

Abstract

Midventricular obstruction is an uncommon variant'of hypertrophie cardiomyopathy (HCM) in which the hypertrophie process predominantly occurs at the left ventricular (LV) papillary muscle level, causing functional separation of the apical region from the outflow tract. In the clinical course, mid-ventricular obstruction (MVO) is known as a cause of chest pain, usually occurring as typical angina on effort or atypical chest pain, and also resulting in some cases, apical myocardial infarction in the absence of coronary artery stenosis. In this case we present a patient with MVO who had atypical chest pain. Coronary angiography revealed significant stenosis at circumflex artery and chest pain was eliminated after successful percutaneous transluminal coronary angioplasty. Though chest pain can be seen in patients with MVO due to oxygen supply/demand mismatch, coronary artery disease should be kept in mind even in the absence of typical angina.