Authors: I. Zvánovcová 1; J. Veselka 1; D. Tesař 2; T. Urbanová 1; M. Mates 1; P. Telekeš 1; S. Valek 1; T. Honěk 1; P. Neužil.p. Niederle 3 2 Authors‘ workplace: Oddělení srdeční chirurgie FN Motol, Praha, primář MUDr. T. Honěk, CSc. Klinika zobrazovacích metod FN Motol, Praha, přednosta prof. MUDr. S. Tůma, CSc. Oddělení kardiologie Nemocnice Na Homolce, Praha, primář doc. MUDr. P. Niederle, DrCs. primář MUDr. T. 1 Published in: Prakt. Lék. 1999; (1): 25-26 Category:
The authors present the case of a 47-year-old female patient referred for catheterization withthe diagnosis of coronary disease, angina pectoris grade III and insignificant aortal stenosiswhere after a subsequent echocardiographic examination hypertrophic obstructive cardiomyo-pathy (HOCM) was revealed with a maximum pressure gradient of 70 mm Hg in the leftventricular outflow tract. Because of persistent symptomatology despite medicamentous treat-ment by a beta-blocking agent the authors performed percutaneous transluminal septalmyocardial ablation (PTSMA) and a achieved a maximum gradient of 40 mm Hg. With regardto the partially successful treatment and the persistence of an AV block grade III after PTSMAa two-cavity pacemaker was implanted with reduction of the AV conduction. The achievedresulting gradient was 10 mm Hg. The authors discuss contemporary possibilities as regardsdiagnosis and treatment of HOCM.
Key words: hypertrophic obstructive cardiomyopathy - percutaneous transluminal septalmyocardial ablation - cardiac pacing.O.
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