P119 WHEN THE ELECTROCARDIOGRAM CHANGES YOUR DIAGNOSIS
| العنوان: | P119 WHEN THE ELECTROCARDIOGRAM CHANGES YOUR DIAGNOSIS |
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| المؤلفون: | R Magnano, N Diella, L Pezzi, A Corazzini, C Cappelli, F Ricci, E Genovesi, E Verrengia, F Fulgenzi, P Vitulli, D Forlani, A D‘Alleva, S Gallina, M Di Marco, L Paloscia |
| المصدر: | European Heart Journal Supplements. 25:D84-D84 |
| بيانات النشر: | Oxford University Press (OUP), 2023. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine |
| الوصف: | Sarcomeric hypertrophic cardiomyopathy is among the most common genetic cardiovascular diseases.Clinical,electrocardiographic and echocardiographic evaluation plays a crucial role in the diagnosis and initial framing of the hypertrophic phenotype. A 51–year–old Caucasian man with multiple myeloma,previous autologous transplant,undergoing chemotherapy for disease recurrence,without cardiovascular risk factors or family history of MCV or MCI came to our outpatient clinic for a follow–up visit.At another center,cardiac amyloidosis was diagnosed due to the echocardiogram finding of concentric left ventricular hypertrophy. Patient asymptomatic for angor,NYHAI dyspnea,heart palpitation,syncope,presented with rhythmic cardiac action,2/6 systolic murmur at centrum and tip,no central or peripheral stasis.On ecg sinus bradycardia at fc57 bpm,PR202 msec,high QRS V4–V6 voltages with negative T waves in infero–lateral site,suggestive for left ventricular hypertrophy. On echocardiogram:concentric left ventricular hypertrophy with posterolateral papillary hypertrophy,preserved contractile function,FE 62%,grade I diastolic dysfunction,no signs of elevated filling pressures,left atrium and right ventricle in normal range;tripartite aortic valve in absence of gradients,prolapse of the LAM(A1–A2)with mild grade insufficiency,mild tricuspid insufficiency. At cardiac MRI:non–dilated left ventricle with concentric hypertrophy,maximum thickness 16mm at basal SIV level,apical inferior wall,15mm anterior wall,anterolateral media,apex systolic obliteration 14mm,FE 64%.Right ventricle and atria in normal.T2–STIR sequences tenuous hyperintensity at infero–lateral media wall,inferior apical wall and lateral,increased T2 mapping in relation to myocardial edema. Subendocardial LGE of middle infero–lateral,apical lateral and postero–medial papillary wall,slight increase in native T1 mapping,ECV 27%,picture of sarcomeric hypertrophic heart disease.Holter ecg showed no arrhythmias;at HCM score low risk,no indication for ICD implantation. The patient was undergoing genetic screening test for HCM.The presence of left ventricular hypertrophy may mimic different forms of hypertrophic cardiomyopathy,leading to misdiagnosis or delayed diagnosis.Differential diagnosis,ecg and specific use of imaging tests are of paramount importance. |
| تدمد: | 1554-2815 1520-765X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::2613a3b20ba1a81e8234df6051125e5b https://doi.org/10.1093/eurheartjsupp/suad111.201 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........2613a3b20ba1a81e8234df6051125e5b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15542815 1520765X |
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