Key result
Rapid T-wave inversion progression precedes imaging detection of preclinical apical hypertrophic cardiomyopathy.
Why the study?
Deep T-wave inversion in mid- to lateral precordial leads is an electrocardiographic marker of apical hypertrophic cardiomyopathy, but its temporal trajectory is variable.
Case Report (n=1)
Rapid progression of T-wave inversion following prolonged electrocardiographic quiescence can serve as an early phenotypic cue for apical hypertrophic cardiomyopathy, necessitating timely cardiac magnetic resonance imaging for definitive diagnosis.
Answers are grounded in this paper and cite their sources.
T-wave inversion progression may precede imaging in apical HCM; single case leaves open ECG surveillance utility.
Deep T-wave inversion (TWI) in the mid- to lateral precordial leads is a recognized electrocardiographic marker of apical hypertrophic cardiomyopathy (ApHCM), although its temporal trajectory is variable. We report a 39-year-old hypertensive, non-athlete male who exhibited stable, low-amplitude biphasic T waves for four years, followed by rapid progression in the fifth year to giant, asymmetric TWI (10 mm). At the onset of this escalation, transthoracic echocardiography revealed relatively increased apical wall thickness compared with basal segments, although still within normative limits, which may represent an early phenotypic cue of ApHCM that was not clinically recognized. Subsequent echocardiography confirmed ApHCM, and cardiac magnetic resonance (CMR) substantiated isolated apical hypertrophy, indicating electro-anatomical conversion during the fifth year despite well-controlled blood pressure. This case highlights that rapid TWI progression following prolonged quiescence should prompt clinical suspicion for ApHCM. Given the potential for false-negative echocardiographic findings, close surveillance and timely CMR are essential for definitive diagnosis.
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X.F. Steven Zheng (2025) conducted a case report in Apical hypertrophic cardiomyopathy (n=1). Rapid progression of T-wave inversion was evaluated on Detection of apical hypertrophic cardiomyopathy. Rapid progression of T-wave inversion following prolonged quiescence preceded the echocardiographic and cardiac magnetic resonance detection of preclinical apical hypertrophic cardiomyopathy.
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