My name is Fabrizio and I am 66 years old, I was born and live in Tuscany. I have lived with a non-obstructive Hypertrophic Cardiomyopathy (CMI) since birth. My medical history begins at the age of 18 with the intuition of a cardiologist from the hospital in my country, who takes me to the hospital in Siena to do an echocardiogram. I still remember that it was a huge machine that filled almost the whole room (I think one of the first in Tuscany) and diagnosed me with the disease.

From that moment my life changes with the awareness of having a rare disease. At the age of 20 I am visited by 3 different famous cardiologists, who make different diagnoses, and one of them proposes to take me to the United States to operate, with an operative risk of 50%. The other two advise to see how it would have evolved over time and, if necessary, to intervene in case of aggravation. Of course, given the high risk, I decided not to operate and to periodically check myself at a cardiologist in Arezzo. I spent the next 25 years quite well, working intensively as an entrepreneur until at the age of 45 my cardiologist, very honestly told me that, given the evolution of Cardiomyopathy, he directed me to contact the
Prof. Franco Cecchi of Florence.

From that moment and we are in 1999, I consciously begin to understand what disease I had and what my lifestyle should be, even if I have not always followed the indications given. In fact, in 2001 I was implanted with an ICD for a severe arrhythmia, a sustained ventricular tachycardia, which was then replaced in 2007 and 2015. In the meantime, I undergo a genetic analysis, which specifies the diagnosis of familial sarcomeric HCM, which was then also carried out on my son , my sister, my two nieces, with confirmation of the diagnosis of hypertrophic cardiomyopathy in them too, with different manifestations and symptoms.

Of course, as the years go by, life changes, even if I can travel, work, meet friends, I feel more and more fatigue, breathing difficulties. In 2009, I was advised for coronary angiography, which demonstrates coronary artery disease, with 90% narrowing of a vessel and occlusion of one of its collateral. It is resolved with angioplasty and the implantation of a stent at the Careggi Hospital in Florence. The coronary angiography was then repeated in 2013, 2016 and 2018. The presence of an apical aneurysm is also demonstrated and a cardiac CT scan shows that there is a thrombus inside the apical aneurysm. In addition to the therapy, I must also take anticoagulant drugs, which dissolve the thrombus, but which I will have to take for life, with the obligation of having to check the INR value every 20-30 days.

In 2016 while I was retired at home, I suddenly start to breathe badly and I am transported to the Arezzo hospital in red code for pulmonary edema, which is then quickly resolved. This event marked me a lot from a psychological point of view, because for the first time I was really afraid of not making it. In fact, I slow down the pace of work a lot and I begin to think that life is the best asset to safeguard. I start a therapy to prevent heart failure with 2 Lasix tablets a day, which really change my way of life and force me to stay at home and go to well-known places to use the toilets. I am offered a cardiac surgery to replace the mitral valve, but while I am awaiting hospitalization, in September 2018 I have a new pulmonary edema while I am, fortunately with my wife, in Pontedera. Having resolved this decompensation too, with the help of Prof. Cecchi, I was transferred by ambulance to the Policlinico di Monza (center of excellence for cardiomyopathies), where three days later I was operated on by Prof. Ferrazzi. Before the surgery, I

he informed me of the operative risk (about 10% compared to a risk usually lower than 1-2%), but he also reassured me, telling me that I would make it. The operation was complex, with resection of the left ventricular aneurysm (aneurysmectomy), revascularization with by-pass on the obtuse margin branch, and mitral valve replacement. He succeeded brilliantly, but I come out very prostrate and take a long time to recover my strength .. I remain in the hospital for another 30 days and during the hospitalization I have intense chest pains, until a large area of ​​anterior and posterior thoracic herpes zoster appears (called popularly "St. Anthony's fire"), which I will take three months to resolve. An incredible suffering !!! The hospital stay was long and painful and I came out with my great desire to heal, but also above all with the presence and constant help of my wife. Among other things, during the rehabilitation in Monza I had also been subjected to ablation for recurrent atrial flutter, then again electrically cardioverted at the hospital of Santa Maria Nuova in Florence after 2 months, but then never reappeared. To improve my ability to make efforts, I still went through cardioriahabilitation cycles at the Arezzo hospital.

How do I feel after the surgery? I am aware that I am a heart patient, but after having overcome many crises and obstacles, I feel able to lead an almost normal life. In the best moments I do light physical activity every day, I work intellectually at home, in the garden, I take one or two leisure trips a year to Europe with my wife. In the time of COVID 19 I can consider myself a quite happy person, thanks also to the competence and commitment of all those who have assisted me