A 52 year old gentleman with no previous health ailments had an episode of sudden loss of consciousness while shopping. He ignored it and continued with his daily activities. Unfortunately, he again became unresponsive at home. Luckily, he was administered CPR and resuscitated. On admission, he was found to have grossly thickened left ventricle on echocardiography with obstruction to blood flow. This condition is called hypertrophic obstructive cardiomyopathy. This condition predisposes the patient to electrical rhythm disturbances which can be severe enough to cause cardiac arrest. Interestingly, this patient also had a critical block with clot formation in the principal artery of theheart which is called the heart called the left anterior descending artery.
The patient underwent angioplasty and stenting to this artery with restoration of flow. He later underwent implantation of a special cardiac device called AICD. This device has leads which lie in the cardiac chambers and detect ventricular tachycardias within seconds of their onset, and delivers a small intra- cardiac shock to reset the heart rhythm to normal. This is a life saving device in patients with HOCM. Interestingly, this patient had presence of two equally threatening cardiac conditions simultaneously. However, appropriate intervention at the right time gave salutary response and saved the patient’s life.