# Successful management of ischaemic symptoms in a patient with asymmetric septal hypertrophy: a grand round case report

## TL;DR

A 30-year-old man with hypertrophic cardiomyopathy and chest pain was successfully treated with ethyl alcohol ablation, reducing his symptoms and improving his condition.

## Contribution

The case demonstrates the effectiveness of ethyl alcohol ablation in managing ischaemic symptoms in a patient with asymmetric septal hypertrophy.

## Key findings

- Ethyl alcohol ablation reduced left ventricular outflow tract obstruction in the patient.
- The procedure provided significant symptom relief for a patient with long-standing HCM-related chest pain.
- The case supports individualized treatment approaches for HCM patients with ischaemic symptoms.

## Abstract

Hypertrophic cardiomyopathy (HCM) is a genetic heart disease that can lead to heart failure, atrial fibrillation, and ischaemic symptoms. Managing patients with HCM and ischaemic symptoms is challenging, and several treatment options have been proposed.

A 30-year-old male patient presented with severe chest pain that had been ongoing for more than 30 min at rest. He was diagnosed with HCM and had periodic chest pain since the age of 14. He underwent two separate ethyl alcohol ablations of the first septal branches of the left anterior descending and posterior descending arteries, which relieved his symptoms.

This case report highlights the challenges in managing patients with HCM and ischaemic symptoms. In this patient, the use of ethyl alcohol ablation was effective in reducing left ventricular outflow tract obstruction and improving symptoms. Ethyl alcohol ablation is a minimally invasive procedure that has been shown to be effective in symptomatic patients with HCM. Overall, this case report emphasizes the importance of individualized treatment for patients with HCM and the potential benefits of alcohol ablation in this population.