Hypertrophic cardiomyopathy with progression from apical hypertrophy to asymmetrical septal hypertrophy: a case...

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Genetic Cardiology

Background:

• Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease.
• Apical hypertrophic cardiomyopathy (AHC) is a distinct subtype characterized by distal left ventricular hypertrophy.
• Morphological changes in HCM can occur over time, but progression from AHC to other forms is less commonly documented.

Observation:

• A 41-year-old male presented with abnormal electrocardiography findings.
• Initial transthoracic echocardiography revealed left ventricular hypertrophy localized to the distal left ventricle, consistent with AHC.
• A decade later, the patient experienced chest pain, and repeat echocardiography demonstrated superimposed asymmetrical septal hypertrophy.

Findings:

• The case illustrates a dynamic morphologic evolution of hypertrophic cardiomyopathy.
• The progression from isolated apical hypertrophy to combined apical and asymmetrical septal hypertrophy was observed over a 10-year period.
• This suggests that hypertrophic cardiomyopathy can exhibit significant changes in left ventricular morphology over time.

Implications:

• This case highlights the potential for hypertrophic cardiomyopathy to undergo significant morphological transformation.
• Understanding such evolutionary patterns is crucial for accurate diagnosis, risk stratification, and long-term management of HCM patients.
• Further research into the mechanisms driving these morphologic changes may offer new therapeutic targets.