Hypertrophic cardiomyopathy and ischemic heart disease: The problem of pathology combination

Abstract

Hypertrophic cardiomyopathy (HCM) is a disease with left ventricular hypertrophy caused by mutations in the genes of myocardial contractile proteins, whose frequency is about 0.5%. Due to the high incidence of anginal pain and marked changes in ECG with HCM, the problem of diagnosing the combination of HCM and coronary artery disease (CAD) presents a rather difficult task for the clinician. The complexity of this diagnosis is due to the ability of standard methods of instrumental examination (ECG, a test with physical activity, stress tests in conjunction with visualization of the myocardium) to detect myocardial ischemia in both СAD and HCM. In such cases, the coronary angiography, or multispiral computed tomography of coronary arteries (in patients with low СAD risk) remains the gold standard for detecting atherosclerotic lesions of the coronary arteries. The possibility of combining HCM and СAD in patients of older age groups raises the question of the features of the course of diseases and the prognosis of such patients.