Atrial fibrillation and hypertrophic cardiomyopathy in a young patient. Risk stratification for thromboembolism. A case report

Abstract

Intr oduction .   Atrial fibrillation is the most commonly diagnosed arrhythmia in patients with hypertrophic cardiomyopathy (HCM). According to current clinical guidelines, diagnostic testing for arrhythmias should be performed on all patients with HCM, regardless of their complaints, echocardiographic findings, or age. Given the high thromboembolism risk, anticoagulant therapy is prescribed to patients with HCM complicated by atrial fibrillation in all cases, regardless of the CHA 2 DS 2 -VAS c  score. Brief description.  This article presents a case of a young patient diagnosed with HCM without left ventricular outflow tract obstruction. During his examination, Holter electrocardiographic monitoring revealed episodes of paroxysmal atrial fibrillation. Given the patient’s young age, the short duration of the episodes of paroxysmal atrial fibrillation, and, unfortunately, the continued caution of many practicing physicians regarding the prescription of anticoagulant therapy, questions may have arisen regarding the need to initiate therapy at this stage. Discussion .   However, this case demonstrates the importance of diagnostic testing for arrhythmia in patients of any age diagnosed with HCM, as well as the need for timely initiation of anticoagulant therapy, regardless of risk stratification.