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<p>Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disorder characterized by myocardial hypertrophy, which can lead to diverse clinical manifestations. Emerging evidence suggests an association between HCM and lower gastrointestinal (GI) bleeding, although the underlying mechanisms remain poorly understood. We present the case of a 46-year-old man with pan-diverticular disease who was admitted with hematochezia and symptomatic anemia. His condition was further complicated by a type 2 non-ST segment myocardial infarction (NSTEMI) and ventricular tachycardia. During his evaluation, he was newly diagnosed with HCM. The patient required serial transfusions and extensive endoscopic and radiologic evaluations. CT angiography identified active colic artery bleeding likely in the setting of acquired von Willebrand factor dysfunction, successfully treated with coil embolization. He underwent resuscitation, intensive care management, and placement of an implantable cardioverter-defibrillator (ICD) for secondary prevention of sudden cardiac death. This case highlights the potential association between HCM and lower GI bleeding, emphasizing the need for a multidisciplinary approach in managing patients with concurrent cardiovascular and gastrointestinal disorders. Early recognition and comprehensive treatment strategies are crucial in optimizing patient outcomes.</p>

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Bleeding with a Thick Heart: A Rare Case of Lower Gastrointestinal Bleeding in Hypertrophic Obstructive Cardiomyopathy—A Case Report and Comprehensive Literature Review

  • 期刊论文

  • 发表日期：

    2025年4月12日

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  • Andrew Ndakotsu,
  • Akinwale Chris Iyeku,
  • Ramya Vasireddy,
  • Ted Akhiwu,
  • Albert D. Osei

摘要

Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disorder characterized by myocardial hypertrophy, which can lead to diverse clinical manifestations. Emerging evidence suggests an association between HCM and lower gastrointestinal (GI) bleeding, although the underlying mechanisms remain poorly understood. We present the case of a 46-year-old man with pan-diverticular disease who was admitted with hematochezia and symptomatic anemia. His condition was further complicated by a type 2 non-ST segment myocardial infarction (NSTEMI) and ventricular tachycardia. During his evaluation, he was newly diagnosed with HCM. The patient required serial transfusions and extensive endoscopic and radiologic evaluations. CT angiography identified active colic artery bleeding likely in the setting of acquired von Willebrand factor dysfunction, successfully treated with coil embolization. He underwent resuscitation, intensive care management, and placement of an implantable cardioverter-defibrillator (ICD) for secondary prevention of sudden cardiac death. This case highlights the potential association between HCM and lower GI bleeding, emphasizing the need for a multidisciplinary approach in managing patients with concurrent cardiovascular and gastrointestinal disorders. Early recognition and comprehensive treatment strategies are crucial in optimizing patient outcomes.