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Syncope in an elderly man with hypertrophic obstructive cardiomyopathy
  1. Nina B Curkovic1,
  2. Daniel E Clark2,
  3. Sean G Hughes2
  1. 1 Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee, USA
  2. 2 Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Dr Daniel E Clark, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA; daniel.e.clark{at}vumc.org

https://doi.org/10.1136/heartjnl-2022-321222

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    Clinical introduction

    A man in his 60s presented after syncope associated with palpitations, dyspnoea and fatigue. History was notable for hypertrophic obstructive cardiomyopathy (HOCM) and stage IV non-small cell lung cancer treated with durvalumab (discontinued 4 months prior due to pneumonitis). Two weeks prior, he was diagnosed with influenza A pneumonia and recovered. Vitals demonstrated borderline hypotension (95/66 mm Hg) and tachycardia (103 bpm). Electrocardiography revealed sinus tachycardia with ST-elevation in aVR and diffuse ST-depression in V3-V6. Troponin-I was elevated at 174.14 ng/mL. Cardiac catheterisation revealed no significant coronary disease, 73 mm Hg peak-to-peak left ventricular outflow tract (LVOT) gradient, grade 3 mitral regurgitation, left ventricular hyperkinesis and aortic pressure …

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    Footnotes

    • Twitter @DanClarkMD

    • Contributors NBC performed the acquisition of data, drafted the manuscript and interpreted the data. DC performed the acquisition of data, critically revised the manuscript and interpreted the data. SH interpreted the data and critically revised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.