Hypertrophic cardiomyopathy in the context of primary hyperaldosteronism, Sjögren’s syndrome, and obstructive uropathy: A case report

Table 1 Clinical timeline of diagnostic and therapeutic milestones

Time point	Clinical event
Initial evaluation	Routine assessment revealed hypokalemia and metabolic alkalosis
Week 1	Hormonal evaluation demonstrated markedly elevated aldosterone levels with suppressed renin activity, confirming primary hyperaldosteronism
Week 2	Transthoracic echocardiography revealed asymmetric septal hypertrophy and dynamic LVOT obstruction (resting gradient 90 mmHg; 130 mmHg with Valsalva)
Week 3	Cardiac magnetic resonance imaging confirmed septal thickness of 26 mm, preserved ejection fraction (72%), and mid-wall late gadolinium enhancement
Week 4	Autoimmune serology and minor salivary gland biopsy established Sjögren’s syndrome
Week 5	Abdominal imaging identified right adrenal adenoma and left-sided obstructive uropathy
Week 6	Spironolactone therapy was initiated; hydroxychloroquine treatment was started
Month 3	Blood pressure and serum potassium levels improved under therapy
Month 9	Clinical stability was maintained; repeat imaging showed no significant regression of septal hypertrophy

LVOT: Left ventricular outflow tract.