Key result
CMR identifies apical HCM when standard TTE is inconclusive.
Why the study?
Apical HCM often manifests with nonspecific symptoms and initial echocardiographic measurements can be inconclusive, requiring advanced imaging such as CMR to establish the diagnosis.
Does cardiac magnetic resonance imaging improve the diagnosis of apical hypertrophic cardiomyopathy in patients with inconclusive transthoracic echocardiography?
Case Report (n=2)
Does cardiac magnetic resonance imaging improve the diagnosis of apical hypertrophic cardiomyopathy in patients with inconclusive transthoracic echocardiography?
Cardiac magnetic resonance imaging is a valuable diagnostic tool for apical hypertrophic cardiomyopathy when standard transthoracic echocardiography is inconclusive.
CMR may clarify apical HCM when TTE is inconclusive; leaves open need for validated diagnostic algorithms.
BACKGROUND: Apical hypertrophic cardiomyopathy (HCM) is a unique subtype of HCM characterized by predominant hypertrophy of the left ventricular apex. Due to its unique morphology, apical HCM often manifests with nonspecific symptoms, leading to a challenging diagnosis. Apical measurements on transthoracic echocardiography may be altered depending on the quality and technique with which the images were obtained; thus advanced imaging, such as cardiac magnetic resonance (CMR), may be needed to establish the diagnosis. CASE SUMMARY: We present 2 cases in which patients presented with nonspecific symptoms and initial transthoracic echocardiography was inconclusive for apical HCM, requiring CMR to better visualize structural changes and establish the diagnosis. DISCUSSION: Apical HCM remains an elusive subtype of HCM given its variable presentation and subtle structural changes. Our cases highlight the significant advantage of CMR to better characterize structural changes that may be overlooked on standard echocardiography to help diagnose apical HCM.
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Li-Jedras et al. (2025) conducted a case report in Apical hypertrophic cardiomyopathy (n=2). Cardiac magnetic resonance (CMR) vs. Transthoracic echocardiography was evaluated on Establishment of diagnosis. Cardiac magnetic resonance (CMR) successfully established the diagnosis of apical hypertrophic cardiomyopathy in cases where standard transthoracic echocardiography was inconclusive.
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