Hypertrophic cardiomyopathy masked by pericarditis

Abstract

Hypertrophic cardiomyopathy used to be regarded as a rare untreatable cause of sudden death in young male athletes. This report is the case of a middle-aged female patient with hereditary hypertrophic cardiomyopathy masked by superimposed pericarditis and revealed by autopsy. This case report illustrates how co-morbidity can hide a crucial diagnosis. This case report also illustrates the value of autopsy disclosing a familial disease that is increasingly recognized and dramatically more treatable than a few decades ago. Sudden death due to hypertrophic cardiomyopathy has become preventable, if the diagnosis is made soon enough. The lessons for patient care from this case include the importance of not missing the diagnosis of hypertrophic cardiomyopathy in female patients.

Keywords: Autopsy; Hypertrophic cardiomyopathy; Pericarditis.

Figure 1. Microscopic examination revealed myocyte disarray with branching myocytes maloriented in different directions, associated with mild interstitial fibrosis (H&E, 40X).

Figure 2. Some areas of myocyte hypertrophy and myocyte disarray had less interstitial fibrosis (H&E, 100X).

Figure 3. There was extensive inflammation of pericardium with recent hemorrhage, and organizing fibrinous exudate (H&E, 40X).