1. EPIC 2012 Live Case Presentation
John S. Douglas Jr.
Andrew Morse

2. Case
66 yo F with recently diagnosed hypertrophic cardiomyopathy , heart failure, and severe mitral regurgitation , syncopal episode led to hospitalization

3. Case Physical Exam GEN – NAD, A+Ox3 NECK – No JVD, bifid carotid pulse
PULM – CTAB
CV – RRR, 4/6 SEM, 3/6 holosystolic murmur radiating to the axilla, murmur accentuated with Valsalva
EXT – No edema

4. Case
Echo
EF 75% , LVOF gradient 90 mm Hg , severe mitral regurgitation , PA pressure 90 mm HG , RV function normal , Septum 2.6 cm

37. Case This morning the patient feels great ; troponin 45
ECHO findings as follows
LVOF gradient 17 mm Hg
Moderate MR , PA pressure 40

38. The End