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Asymmetric apical hypertrophy: ten years experience.
Postgraduate Medical Journal
|June 1, 1986
Summary
Asymmetric apical hypertrophy, a form of hypertrophic cardiomyopathy, primarily affects men over 40. Diagnosis relies on echocardiography, with a good prognosis and infrequent complications observed over 10 years.
Area of Science:
- Cardiology
- Cardiovascular Diseases
Background:
- Asymmetric apical hypertrophy (AAH) is a distinct form of hypertrophic cardiomyopathy (HCM).
- It is characterized by exclusive left ventricular apex involvement and giant T wave inversion in precordial leads.
- AAH is predominantly observed in men over 40 years of age, often with a negative family history and minimal symptoms.
Purpose of the Study:
- To report on 10 years of clinical experience with 31 patients diagnosed with asymmetric apical hypertrophy.
- To describe the clinical characteristics, diagnostic methods, and prognosis of AAH.
- To investigate the relationship between AAH and other forms of hypertrophic cardiomyopathy.
Main Methods:
- Retrospective analysis of 31 patients with AAH over a 10-year period.
- Clinical examination, electrocardiography (ECG), echocardiography (including 2D), and left ventriculography were utilized for diagnosis and assessment.
- Patient data including demographics, symptoms, physical findings, ECG changes, and diagnostic imaging results were reviewed.
Main Results:
- Thirty-one patients with AAH were studied over 10 years.
- Characteristic findings included exclusive apical left ventricular hypertrophy and giant T wave inversion.
- Physical examination revealed faint or absent systolic murmurs and frequently split second heart sound.
- ECG signs showed fluctuation with occasional progression or regression.
- Echocardiography and left ventriculography were crucial for diagnosis and confirmation.
- Complications were infrequent, and the prognosis appeared favorable.
Conclusions:
- Asymmetric apical hypertrophy is a distinct entity within hypertrophic cardiomyopathy, primarily affecting middle-aged men.
- Diagnosis is supported by characteristic ECG findings and confirmed by echocardiography and left ventriculography.
- The condition demonstrates a generally good prognosis with infrequent complications.
- Further research is needed to clarify its relationship with other forms of HCM.