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Malignant anomalous right coronary artery associated with mid-cavitary hypertrophic obstructive cardiomyopathy
  1. Krishna Kumar Mohanan Nair1,
  2. Arun Gopalakrishnan1,
  3. Sonali Avinash Inamdar1,
  4. Ajitkumar Valaparambil1,
  5. T R Kapilamoorthy2,
  6. Jaganmohan A Tharakan1
  1. 1Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
  2. 2Department of Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
  1. Correspondence to Dr Arun Gopalakrishnan, Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, Kerala, India; arungopalakrishnan99{at}gmail.com

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A 50-year-old man with sedentary lifestyle presented with history of New York Heart Association class II exertional dyspnoea for 1 year. The electrocardiogram suggested left ventricular hypertrophy with symmetric deep T inversions in lateral chest leads. Two-dimensional transthoracic echocardiography revealed features of hypertrophic cardiomyopathy with mid-cavitary gradient of 38 mm Hg. The aortic valve and the left ventricular outflow tract were normal and there was no significant mitral regurgitation.

Cardiac MRI showed a mid-cavity diastolic interventricular septal thickness of 24 mm and a …

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