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[Apical bilateral hypertrophic myocardiopathy with mitral and greater tricuspid valve insufficiency]
A Friart1, C Philippart, J L Boreux
1Service de Cardiologie, Centre Hospitalier Universitaire de Tivoli, Belgique.
Insights
A rare case of apical hypertrophic cardiomyopathy (HCM) presented with bilateral ventricular involvement and severe valve regurgitation. This finding suggests that distinct hypertrophic cardiomyopathy types may share overlapping features.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Clinical Case Reports
Background:
- Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease characterized by left ventricular hypertrophy.
- Apical hypertrophic cardiomyopathy (AHCM) is a variant typically affecting the apex of the left ventricle.
- Conventional diagnostic criteria for HCM are well-established.
Observation:
- This report details a unique case of non-obstructive apical hypertrophic cardiomyopathy.
- The patient exhibited simultaneous bilateral ventricular involvement (both ventricles).
- Massive mitral and tricuspid valve regurgitation was a significant associated finding.
Findings:
- The bilateral ventricular hypertrophy and severe valvular regurgitation in this AHCM case are unusual.
- These features, while common in other HCM forms, have not been previously reported in AHCM.
- The co-occurrence of these findings challenges strict classification boundaries.
Implications:
- This case supports the notion that different types of hypertrophic cardiomyopathy may represent a spectrum rather than distinct entities.
- It highlights the importance of considering overlapping clinical and morphological features across HCM variants.
- Further research may refine our understanding of HCM pathophysiology and classification.
Abstract:
The case of a patient with non-obstructive apical hypertrophic cardiomyopathy diagnosed on criteria that are now conventional is reported. This case exhibited two special features: the apical hypertrophic cardiomyopathy was bilateral (i.e. the two ventricles were simultaneously involved) and it was associated with massive mitral and tricuspid valve regurgitation. These two features are frequent in other types of hypertrophic cardiomyopathy, but they have not yet been described in apical hypertrophic cardiomyopathy. They support the concept that there is no definite border between the different types of hypertrophic cardiomyopathy.