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Echocardiogram showing thickened interventricular septum and mitral regurgitation in HCM. Cases are on record, in which ablation of the fourth septal artery has been done to ameliorate the obstruction in mid cavity obstruction. Obstruction may occur during recovery and post exercise monitoring of gradient is mandatory.
The patient was found to have a "concealed" posteroseptal pathway (WPW without delta waves) confirmed to have SVT at EP study and was ablated. Here is the Electrophysilogist's note: "Only 1 pathway attachment could be ablated, the second one deep within the CS could not be ablated with high power. The echo was normal.
Previously healthy, taking no medication and exercising regularly. No anginal symptoms asymptomatic during physical exercise. The patient has been scheduled for a PVC ablation procedure. Our patient was referred for EP study with a plan of PVC ablation if possible. Below in Figure-1 is this patient's admission ECG.
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