Anomalous left coronary artery in hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy and anomalous origin of the coronary artery from the opposite sinus are common causes of sudden cardiac death. These entities have rarely been reported together. Here we present the case of a 48-year-old woman with hypertrophic cardiomyopathy and significant left ventricular outflow tract obstruction. She was referred for septal reduction therapy for symptomatic left ventricular outflow tract obstruction refractory to medical therapy. Cardiac catheterization and coronary artery computed tomography angiogram revealed a single coronary artery arising from the right sinus of Valsalva, coursing between the aorta and the right ventricular outflow tract. The patient underwent septal myectomy and placement of an implantable cardioverter defibrillator.

Comparative heart failure profile over a 3-year period in a Romanian general hospital.

BACKGROUND: Heart failure (HF) has become an increasingly significant public health problem, associated with repeated hospitalizations, high costs, low quality of life, and decreased survival rate. The progress of the disease may be slowed if treatment is administered in accordance with current guidelines. OBJECTIVES: To compare the clinical profile of HF patients in a Romanian general hospital over a 3-year period. METHODS AND RESULTS: We studied two cohorts of patients admitted in the cardiology department of a rehabilitation hospital with a diagnosis of chronic HF New York Heart Association class II-IV The first, in 2006, included 415 patients, 67.08 ± 10.59 years; the second, in 2009, included 500 patients, 67.31 ± 11.27 years. Considering all patients, the left ventricle ejection fraction (LVEF) was not statistically different in the two cohorts. Compared to the 2006 cohort, the 2009 female cohort had higher LVEF (60.49% ± 13.41% vs 64.42% ± 13.79%, P < 0.05), while males over 65 years of age had lower LVEF (52.75% ± 15.02% vs 54.37% ± 15.23%, P = NS). For females, the probability of having LVEF <45% was higher in 2006 (odds ratio = 1.573). HF with preserved LVEF was more common in females, both in 2006 (78.2% vs 54.2%) and 2009 (87.2% vs 57.3%). In the 2009 cohort, LVEF was higher both in young patients (59.08% ± 14.22% vs 55.35% ± 14.92%) and patients ≥ than 75 years of age (62.28% ± 13.81% vs 56.79% ± 14.81%) compared to the 2006 cohort. Ischemic heart disease was the main underlying cause for HF in both cohorts. CONCLUSION: HF appeared to have the same clinical profile over a 3-year period. Females diagnosed with HF showed higher rates of preserved LVEF.