Key result
Apical hypertrophic cardiomyopathy can mimic acute coronary syndrome on ECG, requiring multimodal diagnostic evaluation.
Why the study?
Apical hypertrophic cardiomyopathy is an uncommon condition that can mimic acute coronary syndrome and may be overlooked by emergency physicians during chest pain evaluation.
Case Report (n=1)
Apical hypertrophic cardiomyopathy can present with severe ECG changes that mimic acute coronary syndrome, highlighting the importance of echocardiography and biomarkers in evaluating chest pain.
Early echocardiography may differentiate apical HCM from ACS; this case leaves open broader protocol changes pending larger studies.
Apical hypertrophic cardiomyopathy (ApHCM), also referred to as Yamaguchi syndrome, is a distinct variant of hypertrophic cardiomyopathy characterized by localized hypertrophy of the left ventricular apex. It is classically associated with giant T-wave inversion in the precordial leads, with additional T-wave inversion in the inferior and lateral leads on electrocardiography. Because of its uncommon occurrence, the condition may remain unfamiliar to many emergency department (ED) physicians, and it can be easily overlooked during the evaluation of patients presenting with chest pain. We report the case of a 61-year-old male who presented to the ED with an acute-onset retrosternal chest pain and palpitations of 2 h duration. The ECG findings suggested acute coronary syndrome (ACS), but echocardiography and cardiac biomarkers indicated otherwise.
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Ravikumar et al. (2026) conducted a case report in Apical hypertrophic cardiomyopathy (n=1). Apical hypertrophic cardiomyopathy can mimic acute coronary syndrome on ECG, requiring echocardiography and cardiac biomarkers for accurate diagnosis in patients presenting with chest pain.
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