alexa Unmasking of Occult Myasthenia Gravis in Hypertrophic Cardiomyopathy by Beta Blockers
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Unmasking of Occult Myasthenia Gravis in Hypertrophic Cardiomyopathy by Beta Blockers

Srivatsa Nadig1, Aditya Kapoor1*, Ritesh Agrawal2 and Anjali Mishra2
1 Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, India
2 Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, India
Corresponding Author : Aditya Kapoor
Sanjay Gandhi PGIMS
Lucknow 226014, India
Tel: 00915222494220
Fax: 9105222668073
E-mail: [email protected]
Received January 17, 2014; Accepted February 20, 2014; Published February 22, 2014
Citation: Nadig S, Kapoor A, Agrawal R, Mishra A (2014) Unmasking of Occult Myasthenia Gravis in Hypertrophic Cardiomyopathy by Beta Blockers. J Clin Case Rep 4:350. doi:10.4172/2165-7920.1000350
Copyright: © 2014 Nadig S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Association of Hypertrophic cardiomyopathy (HCM) with immune linked disorders like myasthenia gravis is extremely rare. Various pharmacologic agents can potentially precipitate or unmask underlying signs and symptoms of myasthenia gravis. Oral beta blockers are an important mainstay in the pharmacological management of patients with HCM. We report a case of obstructive HCM who when treated with beta blockers developed increasingly severe weakness and fatigue. Detailed clinical examination led to a clinical diagnosis of underlying myasthenia gravis which was secondary to a thymoma. The patient had developed acute unmasking of the latent myasthenia gravis following institution of therapy with beta-blockers. The patient underwent successful resection of the thymic mass and made an uneventful recovery. Symptoms like fatigue, shortness of breath and weakness are common among patients with HCM and are also frequent in patients with myasthenia gravis, sometimes making a clinical diagnosis difficult. It is important for physicians to be aware of such unusual associations to be able to appropriately manage such cases in clinical practice.

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