Back to square one: the role of septal reduction therapy in the era of Mavacamten

Abstract

An 86-year-old-female with hypertrophic cardiomyopathy with persistent obstructive symptoms despite beta blockers and disopyramide was trialed on mavacamten. Although she had improvement in obstructive symptoms, mavacamten was stopped due to reduction in left ventricular ejection fraction even on the lowest dose. Instead, alcohol septal ablation was pursued. This case highlights key considerations surrounding septal reduction therapy in the era of mavacamten.