title: Synchronous cardiac arrest in monozygotic twins with hypertrophic cardiomyopathy--is sudden cardiac death genetically pre-programmed?
abstract: BACKGROUND
  Hypertrophic cardiomyopathy (HCM) is a myocardial disorder characterised by left ventricular hypertrophy (LVH) in the absence of another cardiac or systemic disease capable of producing the magnitude of LVH evident. HCM causes variable symptoms and is one of the leading causes of sudden cardiac death (SCD) in young adults. While various phenotypic features of HCM among monozygotic twin pairs are not uncommonly reported, occurrence of synchronous cardiac arrest among them is not known from literature.
  
  
  METHODS
  We present a case of monozygotic twins with HCM who both had a cardiac arrest post physical exertion in 63rd year of their lives.
  
  
  CONCLUSIONS
  This case highlights potential genetics predisposition of cardiac arrest in patients with HCM despite having different phenotypic expression. SCD may be the only manifestation of patients with HCM. Decision of implantable cardioverter-defibrillator (ICD) placement for primary prevention of SCD should be based on the recommended guidelines, clinical judgment and patient's preference.
authors.affiliation: Department of Cardiology, The Northern Hospital, Melbourne, Victoria, Australia. cygoh9@gmail.com.
authors.forename: Cheng Yee
authors.initials: CY
authors.lastname: Goh
authors.affiliation: Department of Cardiology, The Northern Hospital, Melbourne, Victoria, Australia. Muhammad.asrar@unimelb.edu.au.|The University of Melbourne, Melbourne, Victoria, Australia. Muhammad.asrar@unimelb.edu.au.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Asrar ul Haq
authors.affiliation: Department of Cardiology, The Northern Hospital, Melbourne, Victoria, Australia. vivekm@me.com.|The University of Melbourne, Melbourne, Victoria, Australia. vivekm@me.com.
authors.forename: Vivek
authors.initials: V
authors.lastname: Mutha
authors.affiliation: Department of Cardiology, The Northern Hospital, Melbourne, Victoria, Australia. William.vanGaal@nh.org.au.|The University of Melbourne, Melbourne, Victoria, Australia. William.vanGaal@nh.org.au.
authors.forename: William J
authors.initials: WJ
authors.lastname: van Gaal
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004200:Diseases in Twins / Q000628:therapy; D004562:Electrocardiography; D020022:Genetic Predisposition to Disease; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D014430:Twins, Monozygotic