Hypertrophic Cardiomyopathy

doi:10.1001/jama.1992.03480060092037

Hypertrophic Cardiomyopathy

Kenneth L. Baughman, MD

From Clayton Heart Center, The Johns Hopkins University School of Medicine, Baltimore, Md.

Since this article does not have an abstract, we have provided the first 150 words of the full text.

Excerpt

CASE PRESENTATION —David Elliott, MD

A 53-YEAR-OLD white man with idiopathic hypertrophic cardiomyopathy underwent successful cardiac transplantation in August 1990. His medical history began in childhood when he first noticed decreased exercise tolerance and episodes of near syncope with exertion. He was first seen at Johns Hopkins in 1962, after he failed an army induction examination because of a cardiac murmur.

Cardiac catheterization revealed a thick left ventricular wall with vigorous contractions causing near obliteration of the left ventricular cavity. The diagnosis of hypertrophic myopathy was established. The patient did well until 1968 when he presented with abdominal pain, orthopnea, and severe dyspnea on exertion. An electrocardiogram revealed new atrial fibrillation, with a ventricular response rate of 120 beats per minute, and Q waves in the inferior leads. The patient was given an anticoagulant, normal sinus rhythm was restored by cardioversion, and he was sent home with a prescription