121H Cocaine Induced Hypertrophic Cardiomyopathy

  • 47-year old man,
  • chest pain
    • Troponin Elevation
    •  EKG w/ lateral TWI
  • history of
    • HTN, HLD,
    • HFmrEF (cocaine induced CMY, EF 45%, Grade 2 diastolic dysfunction),
    • HIV, PSUD, DVT
47 year male with chest pain, elevated troponins and chronic cocaine use
CXR shows LVH
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CXR shows LVH
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in diastole
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in diastole
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in diastole
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in systole
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in diastole
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in systole
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in diastole
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in systole
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows LVH in systole
Ashley Davidoff TheCommonVein.net

 

47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows focal circumferential mild proximal narrowing in the LAD
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows focal circumferential mild proximal narrowing in the LAD
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows normal RCA with single punctate focal proximal calcified plaque
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows normal RCA 
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows normal circumflex coronary artery
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
CT shows 3D view of the LAD
Ashley Davidoff TheCommonVein.net
47 year male with chest pain, elevated troponins and chronic cocaine use
Results of functional evaluation shows an LV ejection fraction of 40% and LV mass of 559 grams 
Ashley Davidoff TheCommonVein.net