Contemporary Diagnosis and Management of Hypertrophic Cardiomyopathy: The Role of Echocardiography and Multimodality Imaging

Figure 1. The classical four phenotypes of Maron’s classification based on the location and degree of hypertrophy. Post. = posterior; LV = left ventricle; Ant. = anterior; VS = ventricular septum.

Figure 2. A representative case in which the hypertrophied region is changing along with the helical structure of myocardial fibers. The arrowheads indicate the location of hypertrophy. LV short axis views from the basal (A) to the apex (F).

Figure 3. Schematic diagram of the different variants of HCM based on hemodynamic (obstructive vs. non-obstructive) classification. HCM = hypertrophic cardiomyopathy, LVOT = left ventricular outflow tract, LVOTO = left ventricular outflow tract obstruction, MVO = mid-ventricular obstruction, and LVAA = left ventricular apical aneurysm.

Figure 4. Three-dimensional CT images for the assessment of appropriate septal branch coronary artery for patients with significant left ventricular outflow tract obstruction planned for PTSMA. The arrowheads indicate the septal branch. CT = computed tomography, PTSMA = percutaneous transluminal septal myocardial alcohol ablation. D-dimensional views of the first major septal branch from different angles (A–C).

Figure 5. A representative case of LVOT obstruction. Transesophageal echocardiography (A), CT images for LVOT obstruction (B), and a target septal branch for PTSMA (C).

Figure 6. Representative cases with left ventricular apical aneurysm. Transthoracic echocardiography (A–C) and cardiac magnetic resonance imaging (D–F). Yellow arrowheads indicate apical aneurysms and red arrowheads indicate late gadolinium enhancement.