Left ventricular apical aneurysm in hypertrophic cardiomyopathy as a risk factor for sudden death at any age.
Ethan J RowinBarry J MaronAalap ChokshiMartin S MaronPublished in: Pacing and clinical electrophysiology : PACE (2018)
In hypertrophic cardiomyopathy (HCM) aging has proved protective against sudden death (SD) risk and aggressive recommendations for prophylactic ICDs are uncommon in patients ≥60 years. Nevertheless, we present a patient with an unexpected but aborted sudden death event at the advanced age of 71 years due to a left ventricular apical aneurysm (LVAA) which has emerged as a novel SD marker. Subsequent reappraisal of the Tufts HCM database, specifically the 118 LVAA patients, showed that 36% of SD events occurred at ≥60 years. Of HCM patients ≥ 60 years, SD was 8-fold more common with aneurysm than without aneurysms (16% vs 2%; P < 0.001). Risk in HCM with LVAA persists throughout life and senior LVAA patients should also be considered for primary prevention of SD with the ICD.
Keyphrases
- hypertrophic cardiomyopathy
- left ventricular
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- emergency department
- heart failure
- peritoneal dialysis
- patient reported outcomes
- patient reported
- case report
- acute myocardial infarction
- aortic stenosis
- transcatheter aortic valve replacement
- clinical practice
- left atrial