A case study of apical hypertrophic cardiomyopathy

Apical hypertrophic cardiomyopathy (AHCM) usually involves the apex of the left ventricle and rarely involves the right ventricular apex or both. AHCM is distinguished by the electrocardiogram hallmarks of giant T-waves and the presence of an ‘ace-of-spades-shaped’ left ventricular cavity on cardiac imaging. This paper aims to increase practice nurse awareness of the differential diagnoses of acute coronary syndrome and AHCM by reviewing the case study of a non-Asian patient who presents with dyspnoea on exertion, fatigue, and has a positive nuclear stress test. The correct diagnosis and understanding of AHCM is important for specialist nurses when managing patients presenting with typical chest pain and dramatic T-wave inversions, as these frequently result in inappropriate hospitalisations and testing for suspected coronary artery disease. AHCM often presents as an acute coronary syndrome, therefore these clinical hallmarks warrant the correct diagnosis and medical management when compared to the other varieties of hypertrophic cardiomyopathy.