Extensive Calcification of the Ventricular Septum in Gene-Positive (MYBPC3) Nonobstructive Hypertrophic Cardiomyopathy

We present multimodality imaging of ventricular septal calcification. A 38-year-old man with asymptomatic gene-positive hypertrophic cardiomyopathy was found to have extensive dystrophic calcification of the ventricular septum. We hypothesized that the extensive ventricular septal calcification would represent an area of severe myocardial fibrosis, resulting in calcification secondary to postsurgical (septal myectomy) changes. Calcification of the ventricular septum is a rare finding, not previously described following septal myectomy, that should prompt a comprehensive evaluation and follow-up with multimodality imaging and testing.