Hypertrophic Cardiomyopathy in a Middle Aged Man - A Case Report

Background: Hypertrophic cardiomyopathy (HCM) is a disease of the myocardium with autosomal dominant pattern of inheritance. It is characterized by inappropriate hypertrophy involving either the interventricular septum, apex or left ventricular free wall in isolation or combined. The disease is often asymptomatic and may present for the first time with sudden death especially in young people. Recognition of the condition in our environment is often difficult because of dearth of facilities and expertise for echocardiograghy in most of our hospitals. Objective: To draw attention to the existence of hypertrophic cardiomyopathy in our environment and need to use echocardiography in evaluating patients with cardiac diseases. Method: The medical record of the patient and relevant literature were reviewed. Result: A 47- year old civil servant presented for the first time with a 3- day history of severe, dull retrosternal chest pain and shortness of breath both of sudden onset associated with orthopnoea and paroxysmal nocturnal dyspnoea. He was managed for heart failure secondary to acute myocardial infarction based on clinical and electrocardiographic findings. He was unable to do echocardiography requested on initial presentation. Echocardiography was done 3 years later and revealed HCM. He however died shortly afterwards. Conclusion: Though HCM is a relatively uncommon condition, it does occur in our environment and may mimic other disease conditions. The diagnosis requires a high index of suspicion, availability and utilization of echocardiography in investigating cardiac diseases. Key words: hypertrophic cardiomyopathy, heart failure, myocardial infarction. Afrimedic Journal 2010; 1(2):34-3