biostudies-literatureUnknown30(30)Alabdaljabar MS<h4>Background</h4>Mavacamten use has potential for clinically significant ventricular systolic dysfunction, including with drug-drug interactions (DDI).<h4>Case summary</h4>A 66-year-old male with symptomatic obstructive hypertrophic cardiomyopathy was treated with mavacamten for 1.5 years. He received treatment for Helicobacter pylori infection with a combination therapy including clarithromycin. The patient developed cardiogenic shock (ejection fraction nadir of 21%) in the setting of new atrial fibrillation (AF) with rapid ventricular response and pulmonary infiltrates. A DDI between clarithromycin and mavacamten was felt to precipitate clinical decline. In this case, cardiogenic shock occurred in the setting of clarithromycin, AF, and possible infection. The CYP3A4 inhibitory effect oJACC. Case reports105277https://www.ebi.ac.uk/biostudies/studies/S-EPMC12540262biostudies-literatureCardiogenic Shock in Hypertrophic Cardiomyopathy Treated With Mavacamten and Clarithromycin.PMC12540262Geske JBDesai MAlabdaljabar MSfalseCardiogenic Shock in Hypertrophic Cardiomyopathy Treated With Mavacamten and Clarithromycin.<h4>Background</h4>Mavacamten use has potential for clinically significant ventricular systolic dysfunction, including with drug-drug interactions (DDI).<h4>Case summary</h4>A 66-year-old male with symptomatic obstructive hypertrophic cardiomyopathy was treated with mavacamten for 1.5 years. He received treatment for Helicobacter pylori infection with a combination therapy including clarithromycin. The patient developed cardiogenic shock (ejection fraction nadir of 21%) in the setting of new atrial fibrillation (AF) with rapid ventricular response and pulmonary infiltrates. A DDI between clarithromycin and mavacamten was felt to precipitate clinical decline. In this case, cardiogenic shock occurred in the setting of clarithromycin, AF, and possible infection. The CYP3A4 inhibitory effect o2025-01-01T00:00:00Z2025 Oct2026-06-02T03:14:05.977Z2026-06-02T03:08:51.454ZS-EPMC125402624104391710.1016/j.jaccas.2025.105277