CONGRESS ABSTRACT

  A 65-year-old female patient with a diagnosis of hypertrophic cardiomyopathy, identified following the sudden death of her 10-year-old daughter. The cardiomyopathy initially presented in an obstructive form, with a maximum gradient of 90 mmHg at the left ventricular outflow tract. Coronary angiography showed no significant coronary abnormalities. Since 2008, exercise echocardiography has remained stable, without pathological findings. The patient has a long history of atrial fibrillation (AF), refractory to pharmacological treatment. She underwent four electrical cardioversions, followed by a catheter ablation in 2011, which was unsuccessful. Subsequently, in 2013, she underwent surgical ablation using the Maze technique, also without clinical benefit. In 2016, due to the presence of endocardial thrombosis, a left atrial appendage closure was performed. In May 2022, the patient was hospitalized for pre-heart transplant evaluation, revealing pre- and post-capillary pulmonary hypertension, with reversibility upon nitrates administration. In 2023, following clinical deterioration with signs of cardiac congestion, she was hospitalized again, responding well to diuretic therapy and showing significant improvement after a cycle of Levosimendan. Currently, the patient is managed in the outpatient Day Hospital, receiving monthly cycles of Levosimendan. Her pharmacological regimen includes Sotalol 80 mg, administered three times daily, Canrenone 100 mg, Furosemide 25 mg, and anticoagulation with Warfarin. Despite the complexity of her clinical condition, she remains stable, with regular monitoring of cardiac parametrers, bioumoral parametrers and congestion status. She is currently on the heart transplant waiting list.