Regression of Left Ventricular Hypertrophy in a Case of Adult Hypertrophic Cardiomyopathy: Importance of Clinical Context at Initial Diagnosis

A 24-year-old male with no significant past medical or family history of cardiovascular or neurological disease presented with bilateral paresthesia and weakness of his upper and lower limbs, along with a left facial droop. A few days later he developed a persistent dull left-sided chest pain that was not pleuritic, positional, or exertional in nature. He was initially evaluated in a regional primary health care centre and referred 3weekslater to a tertiary care hospital. The workup of the patient—including extensive genetic testing and family screening—led to the diagnoses of mild Guillain-Barré syndrome (GBS) with associated Bell’s palsy, as well as hypertrophic cardiomyopathy (HCM). Cardiac troponins were not performed in the regional primary health care centre during the episode of chest pain. However, electrocardiography (ECG) displayed normal sinus rhythm and widespread T-wave inversion (Figure 1A).