Apical Hypertrophic Cardiomyopathy – A Diagnosis Often Missed

Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy in the absence of abnormal cardiac loading conditions. Apical HCM (AHCM) is a type of HCM which classically involves the apex of the left ventricle. AHCM patients may present with chest pain, palpitations, dyspnea, syncope, atrial fibrillation, myocardial infarction, embolic events, ventricular fibrillation, or congestive heart failure. Often, based on chest pain and an abnormal electrocardiogram, these patients are treated as acute coronary syndrome (ACS). Here, we describe a patient who was previously treated with ACS but was ultimately diagnosed with AHCM. These patients differ from those of classic HCM in some respects and want attention.