Hypertrophic cardiomyopathy in identical twins: A case series

Authors

Muddasir Ashraf, Advocate Aurora HealthFollow
Fatima Samad, Advocate Aurora Health
Arshad Jahangir, Advocate Aurora HealthFollow
M. Fuad Jan, Advocate Aurora HealthFollow
Patrycja Galazka, Advocate Aurora HealthFollow
A. Jamil Tajik, Advocate Aurora HealthFollow

Recommended Citation

Ashraf M, Samad F, Jahangir A, Jan MF, Galazka P, Tajik AJ. Hypertrophic cardiomyopathy in identical twins: a case series. Eur Heart J Case Rep. 2022;7(1):ytac452. Published 2022 Nov 28. doi:10.1093/ehjcr/ytac452

Affiliations

Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers

Abstract

Background: Hypertrophic cardiomyopathy in identical twins is rare. Cases of hypertrophic cardiomyopathy with homogenous and heterogeneous phenotypes have been described in the literature.

Case summary: We report a pair of monozygotic twins (Twin A and Twin B) with identical morphological expression of hypertrophic cardiomyopathy. On initial evaluation, both twins had resting left ventricular outflow tract obstruction, Grade II diastolic dysfunction, and New York Heart Association (NYHA) Class II symptoms, but they had a different clinical course afterward. Twin A progressed from NYHA Class II to Class III with a high left ventricular outflow tract pressure gradient that was unresponsive to medical treatment and required alcohol septal ablation. Twin B responded very well to medical treatment. Both patients had no risk factors for sudden cardiac death, and neither required an implantable cardioverter defibrillator.

Discussion: The morphology of hypertrophic cardiomyopathy has a strong genetic basis, but epigenetic factors may affect disease expression.

Type

Case Report

PubMed ID

36582594