Case Report: Biventricular Hypertrophic Obstructive Cardiomyopathy in a Patient with Noonan Syndrome
Main Article Content
Abstract
Abstract
Background: Noonan Syndrome (NS) is a genetic condition that presents with characteristics such as short stature, distinctive facial features, and congenital heart issues. Its occurrence is estimated to be between 1 in 1,000 and 1 in 2,500 live births. The syndrome follows an autosomal dominant inheritance pattern. In around 50% of cases, NS is linked to missense mutations in the PTPN11 gene located on chromosome 12, which leads to the abnormal activation of the SHP-2 non-receptor-type protein tyrosine phosphatase.
Case summary: We are presenting a case of a 17-yearold male diagnosed with Noonan syndrome associated with a mutation in the PTPN11 gene. He was initially followed by pediatric cardiology due to a heart murmur and was diagnosed with non-obstructive Hypertrophic Cardiomyopathy (HCM) 13 years ago. A year back, he transitioned to adult cardiology, where he was found to have biventricular obstructive cardiomyopathy.
Downloads
Article Details
Copyright (c) 2025 Alfaraidy K, et al.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.
We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.
Peertechz accomplice with- [CC BY 4.0]
Explanation
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:
License Name |
Permission to read and download |
Permission to display in a repository |
Permission to translate |
Commercial uses of manuscript |
CC BY 4.0 |
Yes |
Yes |
Yes |
Yes |
The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.
Allanson JE, Hall JG, Hughes HE, Preus M, Witt RD. Noonan syndrome: the changing phenotype. Am J Med Genet. 1985;21(3):507-514. Available from: https://doi.org/10.1002/ajmg.1320210313
Van der Burgt I, Berends E, Lommen E, van Beersum S, Hamel B, Mariman E. Clinical and molecular studies in a large Dutch family with Noonan syndrome. Am J Med Genet. 1994;53(2):187-191. Available from: https://doi.org/10.1002/ajmg.1320530213
Marian AJ, Braunwald E. Hypertrophic cardiomyopathy: genetics, pathogenesis, clinical manifestations, diagnosis, and therapy. Circ Res. 2017 Sep 15;121(7):749-770. Available from: https://doi.org/10.1161/circresaha.117.311059
McKenna WJ, Kleinebenne A, Nihoyannopoulos P, Foale R. Echocardiographic measurement of right ventricular wall thickness in hypertrophic cardiomyopathy: relation to clinical and prognostic features. J Am Coll Cardiol. 1988;11(2):351-358. Available from: https://doi.org/10.1016/0735-1097(88)90101-5
Hickey EJ, Mehta R, Elmi M, Asoh K, McCrindle BW, Williams WG, et al. Survival implications: hypertrophic cardiomyopathy in Noonan syndrome. Congenit Heart Dis. 2011;6(1):41-47. Available from: https://doi.org/10.1111/j.1747-0803.2010.00465.x
Boleti O, Norrish G, Field E, Dady K, Summers K, Nepali G, et al. Natural history and outcomes in paediatric RASopathy-associated hypertrophic cardiomyopathy. ESC Heart Fail. 2024;11(2):923–936. Available from: https://doi.org/10.1002/ehf2.14637
Maron MS, Hauser TH, Dubrow E, Horst TA, Kissinger KV, Udelson JE, et al. Right ventricular involvement in hypertrophic cardiomyopathy. Am J Cardiol. 2007;100(8):1293-1298. Available from: https://doi.org/10.1016/j.amjcard.2007.05.061
Guo X, Fan C, Tian L, Liu Y, Wang H, Zhao S, et al. The clinical features, outcomes, and genetic characteristics of hypertrophic cardiomyopathy patients with severe right ventricular hypertrophy. PLoS One. 2017;12(3):e0174118. Available from: https://doi.org/10.1371/journal.pone.0174118
Andelfinger G, Marquis C, Raboisson MJ, Théoret Y, Waldmüller S, Wiegand G, et al. Hypertrophic cardiomyopathy in Noonan syndrome treated by MEK-inhibition. J Am Coll Cardiol. 2019 May 7;73(17):2237–2239. Available from: https://doi.org/10.1016/j.jacc.2019.01.066
Shimizu M, Kawai H, Yokota Y, Yokoyama M. Echocardiographic assessment of right ventricular obstruction in hypertrophic cardiomyopathy. Circ J. 2003;67(10):855-860. Available from: https://doi.org/10.1253/circj.67.855
Roşca M, Călin A, Beladan CC, Enache R, Mateescu AD, Gurzun MM, et al. Right ventricular remodeling, its correlates, and its clinical impact in hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2015 Nov;28(11):1329-1338. Available from: https://doi.org/10.1016/j.echo.2015.07.015
Ho CY, López B, Coelho-Filho OR, Lakdawala NK, Cirino AL, Jarolim P, et al. Myocardial fibrosis as an early manifestation of hypertrophic cardiomyopathy. N Engl J Med. 2010;363(6):552-563. Available from: https://doi.org/10.1056/nejmoa1002659