Hypertrophic cardiomyopathy in the trauma patient: A case report and review of the literature

创伤患者肥厚型心肌病:病例报告及文献综述

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Abstract

INTRODUCTION: Hypertrophic cardiomyopathy (HCM), a prevalent genetic cardiac condition characterized by myocardial thickening, poses unique challenges in trauma care. Sparse evidence seems to agree that HCM patients have worse outcomes following non-cardiac surgeries, particularly emergent procedures. However, despite a prevalence of 1 in 500 in the US population, the intersection of HCM and Advanced Trauma Life Support (ATLS) remains undiscussed in current literature. CASE PRESENTATION: A 54-year-old female with unknown past medical history presented as a level 2 trauma alert following a motor vehicle collision. Due to persistent hypotension and transient bradycardia in the trauma bay a further cardiologic evaluation was performed and found severe hypertrophic obstructive cardiomyopathy (HOCM). CLINICAL DISCUSSION: We report a case of a polytrauma patient found to have severe HOCM as well as provide a review of the literature including pathophysiological considerations in the management of the trauma patient with HCM. CONCLUSIONS: Caring for the trauma patient with HCM requires a multidisciplinary strategy that integrates advanced cardiac imaging and cautious hemodynamic management, underlining the necessity for heightened awareness.

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