[A case of hypertrophic obstructive cardiomyopathy with marked T wave changes during the short-term]

Abstract

A 72-years-old woman was admitted to our hospital for evaluation of giant negative T waves, which appeared for only two days. Chest X-p revealed a cardiomegaly of slight degree and UCG showed ASH (IVS = 21 mm). Coronary arteriography presented no significant stenosis and the left ventricle was spade-shaped. There was a pressure gradient of 65 mmHg between the aorta and the left ventricle during isoproterenol infusion. Furthermore, endomyocardial biopsy showed disarray and fibrosis to a slight degree and fatty degeneration of myocytes with contraction bands. Based on these findings, calcium blocker was administrated under the diagnosis of HOCM. One month after the initiation of this drug, negative T waves gradually became shallow and finally upright with thinning of IVS (12 mm) four month later. We swimise that this T-wave change is primarily based on myocardial hypertrophy as well as being due to the abnormality of myocardial depolarization. We presented a case of HOCM with negative T-wave change of very short duration, which was improved by calcium-blocker and beta-blocker.