Electrocardiographical case. Asymptomatic patient with deep T-wave inversions
P Ting1, K Gunasegaran, W S Teo
1National Heart Centre, Mistri Wing, Singapore. pting33@hotmail.com
Singapore Medical Journal
|June 1, 2007
Summary
This case study highlights apical variant hypertrophic cardiomyopathy (HCM), a condition diagnosed via ECG and imaging in an asymptomatic 45-year-old man. The findings underscore the importance of recognizing subtle ECG changes for early detection of this cardiac condition.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Hypertrophic cardiomyopathy (HCM) is a primary cardiac condition.
- Apical variant HCM is a distinct form requiring specific diagnostic criteria.
Observation:
- A 45-year-old male presented with an abnormal myocardial perfusion scan.
- Electrocardiography (ECG) revealed specific changes: increased QRS voltage and deep T-wave inversions in leads V3-V6, with absent septal Q waves.
- Clinical examination and initial symptoms were unremarkable.
Findings:
- ECG findings were characteristic of apical variant HCM.
- Coronary angiogram and left ventriculogram confirmed apical HCM with normal coronary arteries.
- Transthoracic echocardiography corroborated the diagnosis.
Implications:
- Early identification of apical HCM is crucial, even in asymptomatic individuals.
- Diagnostic imaging and ECG interpretation are key for recognizing this specific cardiomyopathy.
- Management strategies for apical HCM should be tailored to individual patient presentation.
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