Longitudinal Case-Based Presentations in HCM

  • Abdul Moiz Hafiz
  • Jonathan Elias
  • Kanika Mody
  • Jenna Kahn
  • Sahil Khera
  • Ankur Kalra
  • Srihari S. Naidu


A significant volume of data has been published over the past few decades regarding HCM. In 2011 the ACCF/AHA issued guidelines for management and diagnosis, and in 2014 the ESC guidelines were formalized. Nonetheless, the acute and chronic management of HCM is highly nuanced, based on collective experience of many patients. To elucidate the subtleties of management, eight carefully selected cases attempt to depict the medical decision-making process at various stages of illness. Case 1 is a middle-aged male with refractory NYHA Class III symptoms who eventually improved after surgical septal reduction. Case 2 is a young female with history of sudden death and refractory symptoms who required invasive therapy, and a successful alcohol septal ablation was performed due to strong patient preference. Case 3 is a young female without significant outflow tract obstruction but with advanced diastolic heart failure who eventually required a heart transplant. Case 4 depicts severe obstructive HCM in a female with advanced age who after an extended course of medical therapy eventually improved post-alcohol septal ablation. Case 5 is a relatively young female post ICD for SCD with ICD lead complications and atrial fibrillation but well managed medically. Case 6 is a middle-aged male with severe obstructive HCM who required invasive therapy eventually and preferred alcohol septal ablation to surgery. Case 7 is a patient with obstructive HCM referred for alcohol septal ablation who was subsequently determined to have a subaortic membrane and ultimately required surgical treatment. Case 8 is a 40-year-old patient who underwent surgical myectomy but became symptomatic again 3 years after her surgery and eventually underwent alcohol septal ablation. As will become clear, appropriate care of HCM patients requires an individualized and comprehensive approach keeping in view their specific and oftentimes changing presentation, currently available data, and guidelines, all within the confines of a dedicated HCM center.


Case series Hypertrophic cardiomyopathy Long term Follow-up 



American College of Cardiology Foundation


American Heart Association


Cardiac magnetic resonance imaging


Cardiopulmonary resuscitation


Direct current cardioversion


European Society of Cardiology


Exercise treadmill test


Hypertrophic cardiomyopathy


Hypertrophic obstructive cardiomyopathy


Implantable cardioverter defibrillator


International normalized ratio


Left bundle branch block


Late gadolinium enhancement


Left ventricular outflow tract


Non-sustained ventricular tachycardia


New York Heart Association


Right bundle branch block


Systolic anterior motion of mitral valve


Sudden cardiac death


Transesophageal echocardiography


Transthoracic echocardiography


Ventricular tachycardia


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Abdul Moiz Hafiz
    • 1
  • Jonathan Elias
    • 2
  • Kanika Mody
    • 3
  • Jenna Kahn
    • 4
  • Sahil Khera
    • 4
  • Ankur Kalra
    • 5
  • Srihari S. Naidu
    • 6
  1. 1.Division of CardiologySouthern Illinois University School of MedicineSpringfieldUSA
  2. 2.Piedmont Medical Center and Springs Memorial HospitalRock HillUSA
  3. 3.Division of CardiologyRobert Wood Johnson University HospitalNew BrunswickUSA
  4. 4.Massachusetts General Hospital, Harvard Medical SchoolBostonUSA
  5. 5.University Hospitals Cleveland Medical CenterCase Western Reserve University School of MedicineClevelandUSA
  6. 6.Westchester Medical Center-Hypertrophic Cardiomyopathy Center of ExcellenceValhallaUSA

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