Septal alcohol ablation as a treatment for hypertrophic obstructive cardiomyopathy. Case Report

Abstract

Hypertrophic cardiomyopathy is a genetic disease, the most serious event of which is sudden death. Diagnosis is based on imaging findings, noting a hypertrophic undilated left ventricle, in the absence of other pathologies that may explain these alterations. The objective of the medical treatment is to improve functional disability and diastolic filling. In those patients who continue to be symptomatic despite drug treatment, with significant left ventricular outflow tract obstruction, septal myomectomy is recommended; however, septal alcohol ablation is an alternative to surgery. We present a 39-year-old patient with syncope and heart failure, with an image-confirmed diagnosis of hypertrophic obstructive cardiomyopathy, in whom symptoms persisted despite medical treatment, for which septal alcohol ablation was performed, obtaining satisfactory results. Hypertrophic obstructive cardiomyopathy has been considered a rare pathology, however, it is currently being diagnosed more and more, thanks to the greater knowledge of its phenotypic expression. Septal alcohol ablation has proven to be a safe and effective option in our setting, constituting a reasonable alternative treatment to surgery in selected patients.