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Mr. Prem, (name changed) 35 year old

“Prem now lives knowing he had a brush with sudden death”. 

Had recently developed breathlessness on exertion. He initially attributed it to being ‘unfit’ due to his sedentary office job. On Echocardiography, he was detected to have an obstructive HCM. On further assessment, he was found to be an ideal candidate for alcohol ablation. The procedure reduced the thickness of the heart muscle and relieved him of the breathlessness. He underwent an evaluation to decide whether he was at high risk of SCD and hence would benefit from an implantable pacemaker. It was determined that an AICD was not needed at this stage. He is under regular monitoring by the doctors. “HCM cannot be cured or reverted to normal, but we can certainly control the symptoms and constantly evaluate the need to intervene,” says Dr Padmakumar .
 
 

Mr.Ramachandra, 56 yrs old

Mr.Ramachandra, 56 yrs old, came to the hospital with breathlessness on exertion & tightness in the chest since 3 months. He was a hypertensive for 8 yrs, non diabetic and smoked 15 cigarettes per day. He was examined by his family physician for chest discomfort and changes on the ECG showing deep T-wav inversions in the anterior chest leads.  His BP was 150/100.

In view of his symptoms and ECG changes, we noticed coronary arteries and severe LV out flow gradient due to hypertrophic obstructive cardiomyopathy. On enquiry, he had family history of similar complaints and two of his elder brothers had died suddenly which was presumed to be a heart attack.

He underwent an Alcohol Septal Ablation procedure, where 1-2 ml of absolute alcohol was injected into the large septal branch of the LAD artery which results in a small area of necrosis of the ventricular septum which was causing the LV outflow obstruction. Post this his symptoms of breathlessness & chest discomfort disappeared within 24 hrs and thereafter significantly reducing his risk of arrhythmias and sudden cardiac death.

 

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