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Acute myocardial infarction occurring after hypertrophic obstructive cardiomyopathy with paroxysmal atrial fibrillation: a case report.

ABSTRACT: Atheromatous plaque rupture and coronary artery stenosis/occlusion are leading causes of acute myocardial infarction (AMI). Other reasons for AMI are frequently overlooked. We report a rare case of AMI occurring after hypertrophic obstructive cardiomyopathy with paroxysmal atrial fibrillation. Although the patient showed multiple lead ST-T changes on an electrocardiogram and elevated circulating cardiac troponin I concentrations, no stenotic lesions were observed by repeated invasive coronary angiography examinations. Hypertrophic obstructive cardiomyopathy with paroxysmal atrial fibrillation was suspected as the primary cause of AMI. The patient received radiofrequency catheter ablation therapy and was free of atrial fibrillation and myocardial infarction 1 year postoperatively. The clinical management and outcome of the patient are also discussed.

SUBMITTER: Fang D

PROVIDER: S-EPMC9619288 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Acute myocardial infarction occurring after hypertrophic obstructive cardiomyopathy with paroxysmal atrial fibrillation: a case report.

Fang Dingfeng D Xu Jiabin J Bai Bo B Chen Haibo H

The Journal of international medical research 20221001 10

Atheromatous plaque rupture and coronary artery stenosis/occlusion are leading causes of acute myocardial infarction (AMI). Other reasons for AMI are frequently overlooked. We report a rare case of AMI occurring after hypertrophic obstructive cardiomyopathy with paroxysmal atrial fibrillation. Although the patient showed multiple lead ST-T changes on an electrocardiogram and elevated circulating cardiac troponin I concentrations, no stenotic lesions were observed by repeated invasive coronary an ...[more]

PMID: 36310497

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Project description:BackgroundObstructive sleep apnea (OSA) is associated with a higher prevalence of postoperative atrial fibrillation in patients who underwent cardiac surgery. However, whether OSA is a risk factor for postoperative atrial fibrillation after septal myectomy remains unclear. We hypothesized that OSA was associated with postoperative atrial fibrillation after septal myectomy.MethodsA total of 99 patients with hypertrophic obstructive cardiomyopathy who underwent septal myectomy were included in our manuscript. Polysomnography was performed in all patients, and the heart rhythm was continuously monitored during the perioperative period.ResultsIn the present study, 25 (25.3%) patients developed postoperative atrial fibrillation after septal myectomy. The prevalence of postoperative atrial fibrillation was significantly higher in patients with OSA and increased with the worsening severity of OSA. Notably, the apnea-hypoxia index was significantly higher in patients with postoperative atrial fibrillation among the different OSA groups. In receiver operating characteristic analysis, the area under the curve for the apnea-hypopnea index was 0.785 (95% CI: 0.684-0.887, P<0.001); an apnea-hypopnea index of 10.4 was the optimal cutoff point to predict postoperative atrial fibrillation. In the multivariable analysis, apnea-hypopnea index ≥10.4 (odds ratio: 6.29, 95% CI: 2.18-18.14, P=0.001), moderate-to-severe OSA (odds ratio: 4.88, 95% CI: 1.42-16.86, P=0.01), and left atrium diameter (odds ratio: 1.12, 95% CI: 1.03-1.22, P=0.01) were independent risk factors associated with postoperative atrial fibrillation after adjusting for relevant variables. However, the association between the diagnosis of OSA and postoperative atrial fibrillation was no longer statistically significant.ConclusionsThe severity of OSA reflected by the apnea-hypopnea index in patients with obstructive hypertrophic cardiomyopathy who underwent surgery is an independent risk factor for postoperative atrial fibrillation, which is associated with adverse clinical outcomes.

Dataset Information

Acute myocardial infarction occurring after hypertrophic obstructive cardiomyopathy with paroxysmal atrial fibrillation: a case report.

Publications

Acute myocardial infarction occurring after hypertrophic obstructive cardiomyopathy with paroxysmal atrial fibrillation: a case report.

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