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 Table of Contents 
CASE REPORT
Year : 2014  |  Volume : 3  |  Issue : 3  |  Page : 287-289  

Sudden cardiac death, aborted, in healthy 34-year-old Male


Department of Medical, Emergency Specialist, Reliance Industries Ltd., Mumbai, Maharashtra, India

Date of Web Publication24-Sep-2014

Correspondence Address:
Hitesh Shah
Emergency Specialist, Medical Department, Reliance Industries Ltd., Maker Chambers IV, 2nd Floor, 222, Nariman Point, Mumbai - 400 021, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.141652

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  Abstract 

A 34-year-old male, non-hypertensive, non-diabetic, had a sudden onset of cardiac arrest, he was revived and then referred to a cardiologist at an advanced center for further care. His 2D echo revealed hypertrophic obstructive cardiomyopathy, all the other investigations were normal. His father was also found to have a similar condition however the father was asymptomatic. The patient underwent an automated implantable cardioverter-defibrillator implantation and was advised the necessary precautions and care.

Keywords: Automated implantable cardioverter-defibrillator implantation, hypertrophic obstructive cardiomyopathy, sudden cardiac death


How to cite this article:
Shah H. Sudden cardiac death, aborted, in healthy 34-year-old Male. J Family Med Prim Care 2014;3:287-9

How to cite this URL:
Shah H. Sudden cardiac death, aborted, in healthy 34-year-old Male. J Family Med Prim Care [serial online] 2014 [cited 2019 Aug 25];3:287-9. Available from: http://www.jfmpc.com/text.asp?2014/3/3/287/141652


  Introduction Top


A 34-year-old male, non-hypertensive, non-diabetic, had a sudden onset of cardiac arrest, he was revived and then referred to a cardiologist at an advanced center for further care.

His 2D echo revealed hypertrophic obstructive cardiomyopathy (HOCM), all the other investigations were normal. His father was also found to have a similar condition; however, the father was asymptomatic. The patient underwent an automated implantable cardioverter-defibrillator (AICD) implant and was advised the necessary precautions and care.


  Case Report Top


The present case is about a 34-year-old male presented in a small city hospital in India with c/o breathlessness and chest pain, and also complaining of cough since 4-5 days. Where he went into cardiac arrest and was resuscitated and then put on inotropes and antiarrhythmic. He was subsequently discharged with hemodynamically normal status.

No H/O diabetes, hypertension, bronchial asthma.

On examination

S1 and S2 normal but systolic murmur III/IV was heard, murmur increased on standing and reduced on sitting.

Rest all systems normal.

Investigations

Electrocardiogram series shows left ventricular hypertrophy, and promanent P waves [Figure 1].
Figure 1: Electrocardiogram series shows left ventricular hypertrophy, and prominent P waves

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His coronary angiogram was done which was normal.

Magnetic resonance imaging brain was normal.

2D Echo revealed left ventricular ejection fraction 60%, left ventricular hypertrophy and HOCM, mild mitral regurgitation [Figure 2].
Figure 2: 2D Echo report showing hypertrophic obstructive cardiomyopathy with good ejection fraction

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Further course

He was referred to a cardiologist in an advanced center for further management.

He underwent an AICD implantation under local anesthesia and was subsequently discharged with a follow-up schedule.


  Discussion Top


Sudden cardiac death

  • The most common cause of Sudden cardiac death (SCD) in adults over the age of 30 is coronary artery atheroma.

    Although the most frequent cause of SCD is coronary artery disease, other causes include:
  • Non-atherosclerotic coronary artery abnormalities
  • Hypertrophy of ventricular myocardium
  • Myocardial diseases and heart failure.
  • Arrhythmogenic right ventricular cardiomyopathy
  • Hypertrophic cardiomyopathy (HCM)
  • Dilated cardiomyopathy
  • Myocardial infarction.


HCM

Is a primary disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause. It is perhaps best known as a leading cause of SCD in young athletes.

The occurrence of HCM is a significant cause of sudden unexpected cardiac death in any age group and as a cause of disabling cardiac symptoms. Younger people are likely to have a more severe form of HCM.

HCM is frequently asymptomatic until SCD, and for this reason some suggest routinely screening certain populations for this disease.

Familial HCM is inherited as an autosomal dominant trait and is attributed to mutations in one of a number of genes that encode for one of the sarcomere proteins, as was the case in our patient.

The treatment modalities for HOCM range from

Medications, surgical myomectomy, alcohol septal ablation, ventricular pacing, cardiac transplantation.[10]

 
  References Top

1.Wilson JMG, Jungner G. Principles and practice of screening for disease. Public Health Papers. Geneva: World Health Organization; 1968.  Back to cited text no. 1
    
2.Myerburg RJ, Castellanos A. Cardiac arrest and sudden cardiac death. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook on Cardiovascular Medicine. Philadelphia: Saunders Elsevier; 2007. p. 933-73.  Back to cited text no. 2
    
3.Wisten A, Messner T. Symptoms preceding sudden cardiac death in the young are common but often misinterpreted. Scand Cardiovasc J 2005;39:143-49.  Back to cited text no. 3
    
4.Tough SC, Green FH, Paul JE, Wigle DT, Butt JC. Sudden death from asthma in 108 children and young adults. J Asthma 1996;33:179-88.  Back to cited text no. 4
    
5.Wren C, O'Sullivan JJ, Wright C. Sudden death in children and adolescents. Heart 2000;83:410-3.  Back to cited text no. 5
    
6.Tan HL, Hofman N, van Langen IM, van der Wal AC, Wilde AA. Sudden unexplained death: heritability and diagnostic yield of cardiological and genetic examination in surviving relatives. Circulation 2005;112:207-13.  Back to cited text no. 6
    
7.Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet 2007;370:1578-87.  Back to cited text no. 7
    
8.De Vreede-Swagemakers JJ, Gorgels AP, Dubois-Arbouw WI, van Ree JW, Daemen MJ, Houben LG, Wellens HJ. Out-of-hospital cardiac arrest in the 1990's: a population-based study in the Maastricht area on incidence, characteristics and survival. J Am Coll Cardiol 1997;30:1500-5.  Back to cited text no. 8
    
9.Shen WK, Edwards WD, Hammill SC, Bailey KR, Ballard DJ, Gersh BJ. Sudden unexpected nontraumatic death in 54 young adults: a 30-year population-based study. Am J Cardiol 1995;76:148-52.  Back to cited text no. 9
    
10.Liberthson RR. Sudden death from cardiac causes in children and young adults. N Engl J Med 1996;334:1039-44.  Back to cited text no. 10
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    Figures

  [Figure 1], [Figure 2]



 

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