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Association of ST elevation with apical aneurysm in hypertrophic cardiomyopathy

Ozcan Ozeke1, Cagatay Ertan2, Gokhan Keskin2

  • 1Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey.

Indian Heart Journal
|October 4, 2015
PubMed

Insights

Electrocardiographic ST-segment elevation (STE) in leads V4-6 is a strong indicator of apical aneurysms in hypertrophic cardiomyopathy (HCM) patients. This finding aids in detecting this often-missed condition, improving diagnosis and patient care.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrocardiography

Background:

  • Apical aneurysms are an underrecognized complication of hypertrophic cardiomyopathy (HCM).
  • Echocardiography may miss apical aneurysms due to poor image quality of the left ventricular apex.
  • Electrocardiography (ECG) may offer an alternative diagnostic clue.

Purpose of the Study:

  • To compare electrocardiographic ST-segment elevation (STE) in HCM patients with and without apical aneurysms.
  • To assess the diagnostic utility of STE in identifying apical aneurysms in HCM.

Main Methods:

  • A clinical review utilizing MEDLINE literature search and laboratory data.
  • Analysis of electrocardiographic parameters, specifically STE in V4-6 leads.
  • Comparison of STE prevalence between HCM patients with and without apical aneurysms.

Main Results:

  • A significant association was found between STE in V4-6 leads and the presence of apical aneurysms in HCM patients (93% vs 7%, p<0.001).
  • A strong positive correlation (Spearman's ρ=0.895, p<0.001) was observed between STE in V4-6 and apical aneurysm presence.
  • The study included 29 HCM patients without apical aneurysm and 28 with apical aneurysm.

Conclusions:

  • STE in V4-6 leads is a valuable marker for detecting apical aneurysms in HCM.
  • Clinicians, especially echocardiographers, should consider ECG findings, particularly STE in V4-6, for diagnosing apical aneurysms in HCM.
  • Increased attention to ECG may improve the detection of overlooked apical aneurysms in HCM.
Abstract

Keywords:
Apical aneurysmHypertophic cardiomyopathyST elevation

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