Midventricular Obstructive Hypertrophic Cardiomyopathy during Pregnancy Complicated by Pulmonary Embolism: A Case Report

Leila Abid,Ahmed Tounsi,Dorra Abid,Samir Kammoun,Mourad Hentati

doi:10.1155/2012/165918

Abstract

Hypertrophic cardiomyopathy (HCM) with midventricular obstruction (MVO) is a rare condition occurring in 1% of HCM patients. It is characterized by asymmetric left ventricular hypertrophy with MVO and elevated intraventricular pressure gradients. Pulmonary embolism has been associated with mid-ventricular obstructive HCM. Briefly, this case presents an unusual clinical scenario where a young pregnant woman suffering from hypertrophic obstructive cardiomyopathy presents with dyspnea hemodynamic compromise related to pulmonary embolism illustrating hemodynamic challenges created by pregnancy and surgery. We concluded that simple measures such as communication between the cardiology and obstetric teams, understanding of the hemodynamic changes, anesthetic planning, and monitoring were paramount for the success in our patient.

Highlights

Hamada et al concluded that the class Ia antiarrhythmic, cibenzoline can attenuate left ventricular pressure gradients and ameliorate left ventricular dysfunction in patients with hypertrophic cardiomyopathy (HCM) caused by a midventricular obstruction [10]
There was only one case reported by Paranskaya et al [12] which dealt with dynamic left ventricular outflow tract obstruction in pulmonary embolism
It is not the same thing because our patient has an organic obstructive hypertrophic cardiomyopathy and pulmonary embolism was a complication during pregnancy

Summary

Case Report

Midventricular Obstructive Hypertrophic Cardiomyopathy during Pregnancy Complicated by Pulmonary Embolism: A Case Report. Hypertrophic cardiomyopathy (HCM) with midventricular obstruction (MVO) is a rare condition occurring in 1% of HCM patients. It is characterized by asymmetric left ventricular hypertrophy with MVO and elevated intraventricular pressure gradients. Pulmonary embolism has been associated with mid-ventricular obstructive HCM. This case presents an unusual clinical scenario where a young pregnant woman suffering from hypertrophic obstructive cardiomyopathy presents with dyspnea hemodynamic compromise related to pulmonary embolism illustrating hemodynamic challenges created by pregnancy and surgery. We concluded that simple measures such as communication between the cardiology and obstetric teams, understanding of the hemodynamic changes, anesthetic planning, and monitoring were paramount for the success in our patient

Introduction

Findings

Discussion