Isolated extreme right ventricular hypertrophy: A case report

Hypertrophic cardiomyopathy (HCM) can involve the right ventricle (RV), although RV hypertrophy usually exists with left ventricular (LV) hypertrophy and the severity of hypertrophy is milder in the RV than in the LV. We report a case of isolated extreme RV hypertrophy with a maximum RV wall thickness of 40 mm. A 72-year-old man presented with an abnormal electrocardiogram and isolated hypertrophy of the RV apex was found on echocardiography. A diagnosis of HCM was made based on myocardial features on multiple imaging modalities such as the similar myocardial characteristics to LV hypertrophy and systolic thickening. The isolated hypertrophy of the RV apex exhibited partial calcification, which was surrounded by hypoperfused areas of the myocardium on multidetector computed tomography. <Learning objective: Patients with hypertrophic cardiomyopathy (HCM) are characterized by left ventricular hypertrophy unexplained by secondary causes, although right ventricular (RV) involvement can develop. We report a case of isolated extreme RV HCM with a maximum wall thickness of 40 mm accompanied by intramyocardial calcification, highlighting the importance of acknowledging the diverse phenotypes in HCM.>.