Suspected Familial Hypertrophic Cardiomyopathy in a 13-Year-Old Male From an Underserved Region of the Dominican Republic: A Case Report.

In medically underserved communities where longitudinal, coordinated care is limited, patient histories are often complex, with individuals presenting a broad array of concerns and struggling to identify which issues are most urgent. We report the case of a 13-year-old male who presented to our pop-up village clinic with a recent history of episodes of tunnel vision, profuse epistaxis, headache, chest pain, and audible pulse in his ears with both physical and emotional exertion. While at rest in the office, these symptoms were not present. Physical examination showed a thin appearing child presenting with suspected parasitic infection and abnormal cardiovascular findings, including venous distention on the anterior neck and a heart murmur, suggesting a potentially life-threatening condition. Treatment consisted of ivermectin and albendazole for parasitic infection, a multivitamin for nutritional support, and a referral to pediatric cardiology for workup. Here, we describe the challenges of care in an international setting, the importance of gathering a solid history and physical examination, and the disparities associated with hypertrophic cardiomyopathy in underserved communities. This case highlights the importance of access to high-quality healthcare services in underdeveloped and underserved countries to increase patient longevity, improve health equity, and reduce morbidity.