An Unusual Case of Shock in an Octogenarian.

An octogenarian presented to our hospital in shock after being "found down" at home. She was dehydrated, hypernatremic, and suffering from a urinary tract infection. Findings of a murmur and those on electrocardiography led to the performance of echocardiography, with all findings consistent with a diagnosis of hypertrophic obstructive cardiomyopathy. The patient was volume resuscitated and administered antibiotics; after stabilization, she was started on a low-dose beta-blocker. Hypertrophic cardiomyopathy is a common genetic disorder that is usually diagnosed in the second to fifth decades of life. It is an uncommon cause or contributor to shock and is unusually initially diagnosed at an advanced age. We briefly review the diagnosis and management of hypertrophic cardiomyopathy in older adults, particularly in the setting of shock.