Severa compressão sistólica coronariana associada à cardiomiopatia hipertrófica obstrutiva

Abstract

A 65 year old woman with recent onset angina was admitted for acute coronary syndrome without ST elevation. EKG show deep T wave inversion on the anterior and lateral leads.At angiography no coronary stenosis were found, but severe "milking" of the mid left anterior descending coronary artery, up to 100% systolic narrowing was observed ( fig Two dimensional (cross sectional) echocardiography disclosed asymmetric septal hypertrophy (anterior septum 22 mm, posterior wall 10 mm) with severe and diffuse involvement of the entire interventricular septum and anterolateral wall and left intraventricular gradient at rest was confirmed. (LAO 45; CRAN 25). The white arrowhead indicates a angiographic normal mid LAD segment. (LAO 45; CRAN 25). The white arrowhead indicates 100% systolic narrowing of mid LAD segment by severe "milking". Fig. 1 -End diastolic left coronary angiogram Fig. 2 -End systolic left coronary angiogram