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Clinical and echocardiographic aspects of mid-ventricular hypertrophic cardiomyopathy

Francisco Martínez Baca-López1, Ana Lilia Rayas-Gómez, Erick Ramírez-Arias

  • 1Department of Echocardiography, Hospital of Cardiology XXI Century National Medical Center, IMSS, Mexico City, Mexico. drerickrmzarias@hotmail.com

Echocardiography (Mount Kisco, N.Y.)
|June 22, 2005
PubMed

Insights

Hypertrophic cardiomyopathy with apical aneurysm and mid-ventricular obstruction presents unique diagnostic challenges. Echocardiography and cardiac catheterization are crucial for identifying characteristic findings like mid-ventricular obliteration and intraventricular gradients.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) can manifest with complex anatomical variations.
  • Mid-ventricular obstruction presents a diagnostic challenge, often requiring advanced imaging techniques.

Observation:

  • Three cases of HCM with apical aneurysm and mid-ventricular obstruction are presented.
  • Two patients were diagnosed using two-dimensional and Doppler echocardiography, revealing mid-ventricular obliteration, an hourglass image, and paradoxic jet flow.
  • One patient required contrast echocardiography due to suboptimal initial imaging.

Findings:

  • Clinical presentation included angina and dyspnea.
  • Thallium myocardial imaging showed apical perfusion abnormalities, suggesting ischemia or necrosis.
  • Cardiac catheterization confirmed mid-ventricular obliteration, significant intraventricular gradients, and normal coronary arteries.

Implications:

  • Early and accurate diagnosis of this HCM variant is essential for appropriate management.
  • Multimodality imaging plays a critical role in characterizing complex left ventricular outflow tract obstructions.
  • Understanding these specific HCM phenotypes aids in predicting clinical outcomes and guiding therapeutic strategies.

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