Apical hypertrophic cardiomyopathy: pathophysiology, diagnosis and management

Figures

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  Fig. 1. Variants of hypertrophic cardiomyopathy. Different morphologic types of hypertrophic cardiomyopathy: A basal, B midventricular, and C apical

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  Fig. 2. ECG and CMR in relative ApHCM. ECG demonstrates giant negative T-wave inversion in precordial leads and voltage criteria for LV hypertrophy (A). CMR demonstrates a thickened LV apex (13.5 mm) with relative but not absolute apical hypertrophy in diastole (B), apical cavity obliteration in systole (C), a small LV apical aneurysm (D), and the presence of LGE in the apex (E). ApHCM apical hypertrophic cardiomyopathy, CMR cardiac magnetic resonance imaging, ECG electrocardiogram, LGE late gadolinium enhancement, LV left ventricular

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  Fig. 3. Transthoracic echocardiography (A, four-chamber; B, two-chamber) and cardiac magnetic resonance (C, four-chamber; D, two-chamber) in a patient with ApHCM at baseline. Note the increased thickness of the apex and small end-diastolic volume of the LV. Transthoracic echocardiography (E, four-chamber; F, two-chamber) and cardiac magnetic resonance (G, four-chamber; H, two-chamber) in the same patient one year after TA-BSM. Note the significantly reduced thickness of the apex and the increased end-diastolic volume of the LV. ApHCM apical hypertrophic cardiomyopathy, LV left ventricle, TA-BSM transapical beating-heart septal myectomy