{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:21:52Z","timestamp":1760145712095,"version":"build-2065373602"},"reference-count":79,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University\u2014Sofia","award":["D-184\/2022"],"award-info":[{"award-number":["D-184\/2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This case report concerns a 48-year-old man with a history of ischemic stroke at the age of 41 who reported cardiac hypertrophy, registered in his twenties when explained by increased physical activity. Family history was positive for a mother with permanent atrial fibrillation from her mid-thirties. At the age of 44, he had a first episode of persistent atrial fibrillation, accompanied by left atrial thrombosis while on a direct oral anticoagulant. He presented at our clinic at the age of 45 with another episode of persistent atrial fibrillation and decompensated heart failure. Echocardiography revealed a dilated left atrium, reduced left ventricular ejection fraction, and an asymmetric left ventricular hypertrophy. Cardiac magnetic resonance was positive for a cardiomyopathy with diffuse fibrosis, while slow-flow phenomenon was present on coronary angiography. Genetic testing by whole-exome sequencing revealed three variants in the patient, c.309C &gt; A, p.His103Gln in the ACTC1 gene, c.116T &gt; G, p.Leu39Ter in the PLN gene, and c.5827C &gt; T, p.His1943Tyr in the SCN5A gene, the first two associated with hypertrophic cardiomyopathy and the latter possibly with familial atrial fibrillation. This case illustrates the need for advanced diagnostics in unexplained left ventricular hypertrophy, as hypertrophic cardiomyopathy is often overlooked, leading to potentially debilitating health consequences.<\/jats:p>","DOI":"10.3390\/ijms25179385","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T11:12:13Z","timestamp":1724929933000},"page":"9385","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Cautionary Tale of Hypertrophic Cardiomyopathy\u2014From \u201cBenign\u201d Left Ventricular Hypertrophy to Stroke, Atrial Fibrillation, and Molecular Genetic Diagnostics: A Case Report and Review of Literature"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7664-4329","authenticated-orcid":false,"given":"Dolina","family":"Gencheva","sequence":"first","affiliation":[{"name":"First Department of Internal Diseases, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Clinic of Cardiology, University Multi-Profile Hospital for Active Treatment \u201cSveti Georgi\u201d, 4002 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3595-4432","authenticated-orcid":false,"given":"Petya","family":"Angelova","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry and Biochemistry, Medical University\u2013Sofia, 1431 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kameliya","family":"Genova","sequence":"additional","affiliation":[{"name":"Radiology Department, University Multi-Profile Hospital for Active Treatment and Emergency Medicine \u201cN. I. Pirogov\u201d, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Slavena","family":"Atemin","sequence":"additional","affiliation":[{"name":"Genetic Medico-Diagnostic Laboratory \u201cGenica\u201d, 1612 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mila","family":"Sleptsova","sequence":"additional","affiliation":[{"name":"Genetic Medico-Diagnostic Laboratory \u201cGenica\u201d, 1612 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tihomir","family":"Todorov","sequence":"additional","affiliation":[{"name":"Genetic Medico-Diagnostic Laboratory \u201cGenica\u201d, 1612 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fedya","family":"Nikolov","sequence":"additional","affiliation":[{"name":"First Department of Internal Diseases, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Clinic of Cardiology, University Multi-Profile Hospital for Active Treatment \u201cSveti Georgi\u201d, 4002 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donka","family":"Ruseva","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, Hospital of Ministry of Transport, 4004 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanyo","family":"Mitev","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry and Biochemistry, Medical University\u2013Sofia, 1431 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albena","family":"Todorova","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry and Biochemistry, Medical University\u2013Sofia, 1431 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S0140-6736(12)60397-3","article-title":"Hypertrophic cardiomyopathy","volume":"381","author":"Maron","year":"2013","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1161\/01.CIR.92.4.785","article-title":"Prevalence of hypertrophic cardiomyopathy in a general population of young adults. 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