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She reports a known history of Hypertrophic Cardiomyopathy (HCM) with left ventricular outflow tract obstruction and is on daily beta blocker therapy. Cardiology felt her chest pain to be, most likely, the result of coronary supply-demand mismatch in the context of HCM endothelial remodeling (i.e. References Naidu, S. Tower-Rader, A.
Patient underwent surgical closure of fistula and a 2-vessel coronary artery bypass graft surgery, with a LIMA pedicle graft to the LAD, and SV graft to the LCx.Postoperatively, patient was continued on medical therapy with improvement of symptoms.
hours T-wave are getting larger again The patient went for an angiogram at about 7 hours after arrival. Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. IMPRESSION: 1.
He was admitted for monitoring, as his risk of a ventricular dysrhythmia as cause of the syncope is high ( very high due to HFrEF and ischemic cardiomyopathy ). Discussion Thus, no further ECGs were recorded and there was no angiogram or stress test or CT coronaryangiogram. The estimated LV ejection fraction is 35%.
No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. Pattern consistent with Takotsubo's cardiomyopathy." Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc.
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