[Hypertrophic obstructive cardiomyopathy in the right ventricle presenting in the elderly woman: a case report].
A 69-year-old woman was admitted to the hospital for evaluation of a cardiac murmur, which had been indicated at her childhood. On physical examination, a systolic ejection murmur was heard on the lower left sternal border. Chest roentgenogram revealed a cardiomegaly. Echocardiography and MRI showed a thickening of the interventricular septum and the right ventricular (RV) free wall, which obstructed the RV body. At cardiac catheterization, a systolic pressure gradient of 100 mmHg was shown between the RV outflow tract and the apex. There was no pressure gradient in the left ventricle (LV). RV angiocardiograms disclosed a severe obstruction of the RV body, while LV angiocardiograms showed a slight enlargement of the LV with a diffuse hypokinesis of its wall. Myocardial biopsy of both ventricles revealed a bizarre hypertrophy of myocytes and disorganization. The histological findings were more conspicuous in the RV. Based on these findings, this case was diagnosed as hypertrophic obstructive cardiomyopathy (HOCM) in the RV. HOCM in the RV presenting in the elderly, is extremely rare. Our case is also characterized by a concomitant LV involvement, which demonstrated the slightly enlarged LV and the diffuse hypokinesis of its wall.
Yamazaki
K
K
Department of Cardiology, National Sapporo Hospital.
Horimoto
M
M
Igarashi
K
K
Takenaka
T
T
Horie
T
T
D000367:Age Factors; D000368:Aged; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009206:Myocardium / Q000473:pathology; D013599:Systole; D015899:Tomography, Emission-Computed, Single-Photon