Multimodality imaging, including contrast echocardiography and cardiac MRI, successfully diagnosed apical hypertrophic cardiomyopathy in a 64-year-old man after an initially normal echocardiogram.
Case Report (n=1)
This case highlights the critical role of multimodality imaging in accurately diagnosing apical hypertrophic cardiomyopathy when initial echocardiography is unrevealing.
Apical hypertrophic cardiomyopathy (ApHCM) is a less common variant of hypertrophic cardiomyopathy, characterized by predominant thickening of the left ventricular apex. We describe a 64-year-old man presenting with dyspnea and T-wave inversions in the lateral precordial leads. Although initial echocardiography was reported as normal, further imaging revealed an "ace of spades" configuration on ventriculography and an anechoic apical area on off-axis views. Contrast echocardiography confirmed apical wall thickening with systolic obliteration. Cardiac magnetic resonance imaging showed patchy late gadolinium enhancement, and Holter monitoring excluded sustained arrhythmias. This case highlights the role of multimodality imaging in ApHCM.
Briani et al. (Wed,) conducted a case report in Apical hypertrophic cardiomyopathy (n=1). Multimodality imaging was evaluated. Multimodality imaging, including contrast echocardiography and cardiac MRI, successfully diagnosed apical hypertrophic cardiomyopathy in a 64-year-old man after an initially normal echocardiogram.
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