Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy in the absence of abnormal cardiac loading conditions. Apical hypertrophic cardiomyopathy (Yamaguchi syndrome) is a relatively rare HCM phenotype. It is characterized by apical left ventricular hypertrophy, often with the absence of left ventricular outflow tract obstruction. In patients with HCM symptoms of angina are quite common, mostly due to microvascular dysfunction or oxygen supply demand mismatch. Here we present a case of apical hypertrophic cardiomyopathy with concomitant severe coronary artery disease.

Acute coronary syndrome is common term for various clinical conditions such as unstable angina (UA), myocardial infarction without ST segment elevation (NSTEMI) and myocardial infarction with ST segment elevation (STEMI). ACS is one of the leading cause of morbidity and mortality worldwide. The most serious manifestation of this syndrome is STEMI. The main goal of treatment is rapid restoration of blood flow in the infarct related artery. This can be achieved either with conservative (thrombolysis) or invasive (primary or rescue percutaneous coronary intervention – pPCI or rPCI) approach. Based on the data from varoius registries, the rate of complications of these type of interventions is low and they can be safely performed in centers without on site cardiac surgery. The main goal of this paper is to assess in-hospital mortality as well as demographic, clinical and angiographic characteristics of patients with STEMI treated in cardiac catheteterisation lab in the Clinical Hospital Center Zemun during the first year of implementation of pPCI program. The study included 284 consecutive STEMI patients. Total in-hospital mortality was 4.9% and, depending of the severity of heart failure at admission (Killip/Kimball class), the highest mortality was in cardiogenic shock (54,5%). The most common intrahospital complications were complicated infections unrelated to the pPCI procedure (3.5%), vascular complications (2.8%) and early stent thrombosis (2.1%). No patient was reffered to emergency cardiac surgery due to unsuccesfull or complicated pPCI procedure. Our study showed that performing pPCI during the first year of the implementation of pPCI program in the center without on-site cardiac surgery support was safe end effective and resulted in low in-hospital mortality.