Key result
Stress echocardiography revealed a latent risk for heart failure due to the calcified left ventricular myocardium, with the tricuspid regurgitation pressure gradient rising from 23 mmHg at rest to 50 mmHg during exercise.
Case Report (n=1)
Stress echocardiography can unmask a latent risk of congestive heart failure in asymptomatic patients with apical hypertrophic cardiomyopathy and severe myocardial calcification.
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May support stress echocardiography for latent HF risk in calcified apical HCM; hypothesis-generating and requires prospective validation.
Myocardial calcification is rare. An 88-year-old man who had previously been diagnosed with apical hypertrophic cardiomyopathy exhibited left ventricular asynergy on echocardiography before undergoing cholecystectomy. Computed tomography revealed severe calcification in the apical region of the left ventricular myocardium, although the coronary arteries were intact and the hemodynamics on right heart catheterization were normal. The cause of the left ventricular asynergy appeared to be myocardial calcification, thought to be the result of rheumatic fever based on the patient's past history. Stress echocardiography showed a latent risk for the development of heart failure due to the distensibility of the calcified left ventricular myocardium.
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Ito et al. (2015) conducted a case report in Myocardial calcification with apical hypertrophic cardiomyopathy (n=1). Myocardial calcification was evaluated on Tricuspid regurgitation pressure gradient during stress echocardiography. Stress echocardiography revealed a latent risk for heart failure due to the calcified left ventricular myocardium, with the tricuspid regurgitation pressure gradient rising from 23 mmHg at rest to 50 mmHg during exercise.
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