Right ventricular pacing for right ventricular outflow tract obstruction: In a man with biventricular hypertrophic cardiomyopathy

摘要

A 40-year-old man with known hypertrophic cardiomyopathy presented with syncope after coughing. Physical examination revealed a systolic murmur that was accentuated by the Valsalva maneuver. An electrocardiogram suggested biventricular hypertrophy and biatrial enlargement (Fig. 1). Echocardiograms revealed asymmetric septal hypertrophy with a diastolic septal thickness of 2.3 cm, and evidence of flow acceleration across the right ventricular outflow tract (RVOT) and left ventricular outflow tract (LVOT) (Figs. 2 and 3).