Work

Spontaneous myocardial injury in hypertrophic cardiomyopathy: Coexistence of microvascular dysfunction and microvascular obstruction

Year: 2026

Type: article

Abstract: Hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by left ventricular hypertrophy without abnormal loading conditions, often complicated by microvascular dysfunction (MVD), which leads to myocardial ischemia. While MVD in HCM has been extensively described, reports of concomitant microvascular obstruction (MVO) as a feature of spontaneous myocardial injury are scarce. We present a 58-year-old man with genetically confirmed HCM who experienced recurrent chest discomfort attributed to spontaneous myocardial injury. This was evidenced by markedly elevated biomarkers and cardiac magnetic resonance imaging (CMR) findings, including severe inducible myocardial ischemia on stress perfusion, myocardial edema, and MVO. This case highlights the potential coexistence of MVD and MVO in severe HCM, suggesting a complex interplay that may contribute to disease progression. Advanced imaging techniques, particularly CMR, are crucial in detecting myocardial damage and guiding management. Future research should explore the clinical significance of MVO in HCM and its potential as a therapeutic target.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2026.01.047

Authors: Maethas Panyawongkhanti, Nonthikorn Theerasuwipakorn, Apichai Khongphatthanayothin, Pairoj Chattranukulchai

Institutions: Chulalongkorn University, King Chulalongkorn Memorial Hospital, Chulabhorn Royal Academy

Language: English

Topic: Cardiomyopathy and Myosin Studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600