Key result
Apical HCM mimics ACS with deep T-wave inversions in a patient managed conservatively with beta-blockers.
Why the study?
Apical hypertrophic cardiomyopathy frequently mimics acute coronary syndrome due to ischemic-type chest pain and characteristic electrocardiographic changes, making early recognition important to prevent unnecessary invasive procedures.
Case Report (n=1)
No
Apical hypertrophic cardiomyopathy should be considered in the differential diagnosis of patients presenting with ACS-like symptoms and deep T-wave inversions but normal coronary arteries.
Apical hypertrophic cardiomyopathy (ApHCM), or Yamaguchi syndrome, is a morphological variant of hypertrophic cardiomyopathy that frequently mimics acute coronary syndrome (ACS) due to ischemic-type chest pain and characteristic electrocardiographic changes. A 46-year-old woman presented with angina and deep T-wave inversion in precordial leads. Coronary angiography showed normal epicardial arteries. Transthoracic echocardiography revealed localized left ventricular apical hypertrophy with preserved systolic function and the typical "ace-of-spades" cavity configuration, confirming ApHCM. She was managed conservatively with beta-blockers and guideline-directed therapy, with symptomatic improvement. Early recognition prevents unnecessary invasive procedures and facilitates appropriate long-term management.
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Lokesh Shirbhate (2026) conducted a case report in Apical Hypertrophic Cardiomyopathy (Yamaguchi Syndrome) (n=1). Beta-blockers and guideline-directed therapy was evaluated. A 46-year-old woman presenting with acute coronary syndrome-like symptoms and deep T-wave inversions was diagnosed with apical hypertrophic cardiomyopathy and managed conservatively with beta-blockers.
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