MCQ : Echo-26
80 year old male with history of hypertension presenting with dyspnea on exertion.
BP well controlled on Long acting metoprolol and Diltiazem.
Correct diagnosis was made and patient was started on appropriate guidelines directed therapy. Patient retuned 30 days later
Which is your diagnosis?
- Calcific degenerative Aortic stenosis
- Sub-Valvular aortic membrane
- Hypertrophic obstructive cardiomyopathy with systolic anterior motion of the mitral valve
- Mixed severe aortic valve disease and mitral valve disease
What was the therapy?
- Diuretics
- Losartan
- Mavacamten
- Stopping beta blockers and calcium channel blockers
Mavacamten was started to treat Hypertrophic obstructive cardiomyopathy with significant improvement in SAM and reduction in gradient across the left ventricular outflow tract.
- Desai MY, Owens AT, Geske JB, Wolski K, Saberi S, Wang A, Sherrid MV, Cremer PC, Naidu SS, Smedira N, Schaff HV, McErlean E, Sewell C, Balasubramanyam A, Lampl K, Sehnert AJ, Nissen SE. Dose-Blinded Myosin Inhibition in Patients with Obstructive HCM Referred for Septal Reduction Therapy: Outcomes Through 32-Weeks. Circulation. 2022 Nov 6. doi: 10.1161/CIRCULATIONAHA.122.062534. Online ahead of print.
- Desai MY, Owens A, Geske JB, Wolski K, Naidu SS, Smedira NG, Cremer PC, Schaff H, McErlean E, Sewell C, Li W, Sterling L, Lampl K, Edelberg JM, Sehnert AJ, Nissen SE. Myosin Inhibition in Patients With Obstructive Hypertrophic Cardiomyopathy Referred for Septal Reduction Therapy. J Am Coll Cardiol. 2022 Jul 12;80(2):95-108. doi: 10.1016/j.jacc.2022.04.048.
- Zampieri M, Argiro A, Marchi A, Berteotti M, Targetti M, Fornaro A, Tomberli A, Stefano P, Marchionni N, Olivotto I. Mavacamten, a Novel Therapeutic Strategy for Obstructive Hypertrophic Cardiomyopathy. Curr Cardiol Rep. 2021 Jun 3;23(7):79. doi: 10.1007/s11886-021-01508-0.
- Desai MY, Wolski K, Owens A, Naidu SS, Geske JB, Smedira NG, Schaff H, Lampl K, McErlean E, Sewell C, Zhang D, Edelberg JM, Sehnert AJ, Nissen SE. Study design and rationale of VALOR-HCM: evaluation of mavacamten in adults with symptomatic obstructive hypertrophic cardiomyopathy who are eligible for septal reduction therapy. Am Heart J. 2021 Sep;239:80-89. doi: 10.1016/j.ahj.2021.05.007. Epub 2021 May 24.
