[Hypertrophic cardiomyopathy with rapid development of giant negative T-wave within a year: a case report]

A 61-year-old female was admitted to our hospital, presenting hypertension and giant negative T-wave (GNT) on an electrocardiogram (ECG). The ECG taken one year prior to the admission showed left ventricular hypertrophy (LVH) without GNT. Hypertension had been poorly treated during the year previous to her admission. These had been almost no administration of antihypertensive drugs. Echocardiograms, left ventriculograms and magnetic resonance imaging revealed concentric and diffuse LVH. Endomyocardial biopsy of bilateral ventricles disclosed a degeneration of myocytes and their bizarre hypertrophy with disorganization. This pathologic finding was compatible with that of hypertrophic cardiomyopathy (HCM). Although GNT has frequently been noted in apical type of HCM, the alteration from normal T-wave to GNT within a year has rarely been reported. The present case exhibited GNT on an ECG which showed no apical hypertrophy. Since GNT had developed within a year while hypertension was poorly treated, the rapid development of GNT might have been precipitated by hypertension, which possibly altered the hypertrophic pattern of the left ventricle.