Author + information
- Received June 28, 2010
- Revision received August 16, 2010
- Accepted August 24, 2010
- Published online May 10, 2011.
- Chi Young Shim, MD, PhD†,
- Seong-Bo Yoon, MD⁎,
- Young-Jin Kim, MD, PhD‡,
- Jong-Won Ha, MD, PhD† and
- Namsik Chung, MD, PhD†
A 52-year-old woman presented with severe continuous chest pain for 1 h. Her father and sister died suddenly at the age of 50 years. Her vital signs were unstable, and an electrocardiogram showed a 4-mm ST-segment elevation in V3 to V5. Emergency coronary angiogram showed no culprit lesions on 3 major coronary arteries but rhythmical occlusion and kinking of multiple septal branches during systole and partial relaxation during diastole (A and B, Online Video 1). Creatinine kinase-myocardial band increased to 153 ng/ml. Echocardiography and cine magnetic resonance imaging (MRI) demonstrated asymmetric septal hypertrophy and left ventricular outflow tract obstruction, compatible with hypertrophic obstructive cardiomyopathy (C and E, Online Videos 2 and 3). MRI revealed a subendocardial perfusion defect on septum with microvascular obstruction and infarct hemorrhage (F and H). The ST-segment elevation and asymmetric septal hypertrophy with left ventricular outflow tract obstruction disappeared (D and G, Online Videos 4 and 5), and areas of microvascular obstruction were decreased (I) on the sixth hospital day.
- Received June 28, 2010.
- Revision received August 16, 2010.
- Accepted August 24, 2010.
- American College of Cardiology Foundation