Key result
Serial cardiac magnetic resonance imaging over 9 years documented the gradual evolvement of late-onset apical hypertrophy, demonstrating that relative apical hypertrophy can precede traditional criteria.
Why the study?
Apical hypertrophic cardiomyopathy presents diagnostic challenges due to variable presentation, impaired echocardiographic visualization, and dissent on diagnostic criteria regarding absolute versus relative wall thickness thresholds.
Case Report (n=1)
Relative apical hypertrophy can be an early manifestation of apical hypertrophic cardiomyopathy, and serial cardiac MRI can document its gradual evolvement over time.
May aid equivocal apical HCM diagnosis; leaves open validation of relative hypertrophy criteria.
BACKGROUND: Apical hypertrophic cardiomyopathy provides diagnostic challenges through varying presentation, impaired visualization on echocardiography and dissent on diagnostic criteria. While hypertrophic cardiomyopathy in general requires an absolute wall thickness ≥15 mm, a threshold for relative apical hypertrophy (ratio 1.5) has been proposed. CASE SUMMARY: We report the case of a 57-year-old man with newly arisen chest pain and slight T-wave inversions. Serial cardiac magnetic resonance imaging over 9 years documented the gradual evolvement of late-onset apical hypertrophy with apical fibrosis and strain abnormalities. Symptoms, electrocardiographic changes, and relative apical hypertrophy preceded the traditional imaging criteria of hypertrophic cardiomyopathy. DISCUSSION: Relative apical hypertrophy can be an early manifestation of apical hypertrophic cardiomyopathy. Persistent cardiac signs and symptoms warrant a follow-up, as apical hypertrophic cardiomyopathy can evolve over time. Cardiac magnetic resonance imaging readily visualizes apical hypertrophic cardiomyopathy and associated changes in tissue composition and function.
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Doeblin et al. (2020) conducted a case report in Apical hypertrophic cardiomyopathy (n=1). Serial cardiac magnetic resonance imaging was evaluated on Gradual evolvement of late-onset apical hypertrophy with apical fibrosis and strain abnormalities. Serial cardiac magnetic resonance imaging over 9 years documented the gradual evolvement of late-onset apical hypertrophy, demonstrating that relative apical hypertrophy can precede traditional criteria.
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