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Apical hypertrophic cardiomyopathy with midventricular obstruction and apical aneurysm

George Lazaros, Nicolaos Kouvousis, Athanasios Kotsanis

    International Journal of Cardiology
    |October 31, 2006
    PubMed

    Insights

    This case study highlights a rare instance of apical aneurysm in hypertrophic cardiomyopathy. It suggests that factors beyond ischemia may contribute to apical aneurysm development.

    Area of Science:

    • Cardiology
    • Cardiovascular Imaging
    • Pathophysiology

    Background:

    • Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease.
    • Apical HCM can lead to left ventricular outflow tract obstruction and apical aneurysms.
    • Apical aneurysms are typically associated with ischemic heart disease.

    Observation:

    • A 69-year-old female with a history of apical HCM presented with midcavitary obstruction.
    • Coronary angiogram revealed no significant stenotic lesions in epicardial coronary arteries.
    • Myocardial perfusion imaging showed no perfusion defects in the left ventricular apex.

    Findings:

    • The patient developed an apical aneurysm, a rare complication of HCM.
    • Absence of coronary artery stenosis and myocardial perfusion defects challenges the ischemic etiology.
    • This case presents an atypical presentation of apical aneurysm in the context of HCM.

    Implications:

    • Apical aneurysms may arise from non-ischemic mechanisms in HCM.
    • Coexisting or alternative factors likely contribute to apical aneurysm formation.
    • Further research is needed to elucidate the pathophysiology of apical aneurysms in HCM.

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