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[Clinical diagnosis of apical hypertrophic cardiomyopathy]
1Cardiovascular Department, Beijing Friendship Hospital, Beijing 100050, China.
Insights
Electrocardiogram (ECG) findings, including increased R wave amplitude and inverted T waves, are key indicators for diagnosing apical hypertrophic cardiomyopathy (AHCM). These ECG patterns, alongside specific R wave amplitude changes, aid in reliable clinical diagnosis.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Clinical Medicine
Context:
- Apical hypertrophic cardiomyopathy (AHCM) presents unique diagnostic challenges.
- Distinguishing AHCM from other cardiac conditions requires precise clinical and imaging evaluation.
- The role of electrocardiography (ECG) in AHCM diagnosis needs further elucidation.
Purpose:
- To assess the clinical manifestations of AHCM.
- To determine the diagnostic value of ECG in identifying AHCM compared to two-dimensional echocardiography.
- To correlate ECG findings with established diagnostic methods like echocardiography, myocardial scanning, coronary angiography, and left ventriculography.
Summary:
- A study of 29 AHCM cases revealed myocardial ischemia as a primary clinical feature.
- ECG demonstrated characteristic increased R wave amplitude (RV(4)≥RV(5)>RV(3)) and inverted T waves in chest leads.
- Echocardiography and myocardial scanning confirmed left ventricular apical wall thickening, while LVG and angiography showed AHCM with normal coronary arteries in 16 cases.
Impact:
- Identifies specific ECG patterns as crucial for AHCM diagnosis.
- Highlights the utility of ECG as a reliable, non-invasive tool for AHCM detection.
- Provides a foundation for earlier and more accurate diagnosis of apical hypertrophic cardiomyopathy.
Objective:
To evaluate the clinical features of apical hypertrophic cardiomyopathy (AHCM) and the value of ECG for a reliable clinical diagnosis as compared with two-dimensional echocardiography.
Methods:
29 cases with AHCM were studied by with clinical features, ECG, echocardiography, myocardial scanning, coronary angiography and left ventriculography (LVG).
Results:
The major clinical feature of AHCM was myocardial ischemia; ECG showed increased R amplitude and inverted T in chest leads. The increase of R amplitude was in such a pattern that RV(4)>or=RV(5) > RV(3). Thickening of left ventricular apical wall was found with echocardiography and radionuclide myocardial scanning. Exercise electrocardiogram showed myocardial ischemia in 20 cases. LVG and coronary angiography demonstrated apical hypertrophic cardiomyopathy with normal coronary arteries in 16 cases.
Conclusion:
The characteristic inverted T waves and increased R wave amplitude with RV(4)>or=RV(5 > RV3) in the ECG are the important signs for clinical diagnosis of AHCM.