Pulmonary Embolism in a Patient With Hypertrophic Obstructive Cardiomyopathy: Think Outside 'the Box'

摘要

A patient with hypertrophic obstructive cardiomyopathy (HOCM) was admitted with acute heart failure. Echocardiography revealed significantly worsened left ventricular outflow tract obstruction and pulmonary hypertension. Cardiac magnetic resonance imaging showed biventricular dysfunction and, as an unexpected finding, a large embolus in the right pulmonary artery. The patient gradually improved with medical therapy including oral anticoagulation. In HOCM patients, pulmonary embolism may trigger heart failure due to impaired left ventricular filling with consecutive outflow tract obstruction provocation.