Case report

Myocardial ischemia with left ventricular outflow obstruction

Aron F Popov^1* , Christian Bireta^1* , Jan D Schmitto^1,2 , Dieter Zenker¹ , Martin Friedrich¹ , Kasim O Coskun¹ , Ralf Seipelt¹ , Gerd G Hanekop³ and Friedrich A Schoendube¹

¹  Department of Thoracic and Cardiovascular Surgery, University of Göttingen, Germany

²  Division of Cardiac Surgery, Department of Surgery, Brigham and Woman's Hospital, Harvard Medical School Boston, MA, USA

³  Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Germany

author email corresponding author email* Contributed equally

Journal of Cardiothoracic Surgery 2009, 4:51doi:10.1186/1749-8090-4-51

Published:	17 September 2009

Abstract

We report an unusual case of a 32-year old man who was treated for a hypertrophic obstructive cardiomyopathy (HOCM) with a DDD pacing with short AV delay reduction in the past. Without prior notice the patient developed ventricular fibrillation and an invasive cardiac diagnostic was performed, which revealed a myocardial bridging around of the left anterior descending artery (LAD). We suspected ischemia that could be either related to LAD artery compression or perfusion abnormalities due to AV delay reduction with related to diastolic dysfunction.