[SCD-FORUM] 71S 一个49岁的男性肥厚性心肌病患者――de la Torre医生

[SCD Symposium]

71S 一个49岁的男性肥厚性心肌病患者――de la Torre医生
首先，我要问候大家并且祝贺此次有趣论坛的召开。 
在此我有一个病例要与大家一起分享。那是一个数年 
前被诊断为肥厚性心肌病的年轻人（49岁）。现在他 
症状非常明显，静息时有心绞痛、严重心悸并伴眩 
晕，而我们无法确定它属于哪一型。通过心超我发现 
除了间隔厚度达23mm、双压力阶差，一个在左室流出道 
(LVOT)，峰值达68mmHg，另一个在心室内，达145mmHg。他 
现在服用普萘洛尔40mg q8h。

我的问题是：安装双腔起搏器对他是否有益？有必要 
植入ICD吗？哪一个选择更合适呢（起搏器，部分心肌 
切除或室间隔消融）？

再次祝贺这次大会。

Rafael S. León de la Torre医生
Cardiólogo-Ecocardiografista
Centro de atención cardiovascular de Camaguey
Cuba

Sergio Dubner医生
科委会主席
Edgardo Schapachnik
组委会主席
施根灵译 王玲洁校
71S HCM in 49-year-old man. Dr. de la Torre

First of all, greetings. Congratulations for such an interesting event.
I have a case I would like to share. It is a young man (49 years old)
with hypertrophic cardiomyopathy diagnosed years ago.
Now he is very symptomatic, with angina in rest and crises of
palpitations accompanied by dizziness, and we could not document
which type they are. In echocardiogram I have found besides septal
hypertrophy of 23 mm, double gradient, one in LVOT, peak of 68 mmHg,
and another intraventricular, of 145 mmHg. He is being treated with
propranolol 40 mgs per 8 hours.
My question is: would he benefit with a dual chamber pacemaker? Would
it be essential to implant ICD? Which of the options is more
appropriate (pacemaker, myectomy, or septal ablation)?
Once again, congratulations,
Dr. Rafael S. León de la Torre
Cardiólogo-Ecocardiografista
Centro de atención cardiovascular de Camaguey
Cuba

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee