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Related Experiment Video

Updated: Sep 13, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Apical Hypertrophic Cardiomyopathy With Endomyocardial Calcification: A Multimodality Imaging-Based Case Report.

Sho Tanabe¹, Chisato Takamura¹, Masahiro Terashima¹

¹Cardiology, Cardiovascular Imaging Clinic Iidabashi, Tokyo, JPN.

|July 28, 2025

Summary

Apical hypertrophic cardiomyopathy (ApHCM) with endomyocardial calcification is rare. Multimodality imaging revealed apical hypertrophy and calcification, suggesting potential chronic ischemia and guiding clinical management.

Keywords:

apical hcm cardiovascular magnetic resonance imaging (cmr)endomyocardial calcification myocardial perfusion reserve myocardial strain

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Area of Science:

Cardiology
Medical Imaging
Pathophysiology

Background:

Apical hypertrophic cardiomyopathy (ApHCM) with endomyocardial calcification is infrequently reported, leading to poorly defined imaging characteristics.
Early detection of ApHCM is crucial for appropriate patient management and prognosis.

Observation:

A 53-year-old woman presented with abnormal electrocardiographic findings.
Multimodality imaging, including echocardiography, coronary CT angiography, and cardiac MRI, diagnosed ApHCM with endomyocardial calcification.

Findings:

Adenosine stress perfusion cardiac MRI revealed a circumferential perfusion defect in the apical myocardium.
Myocardial strain analysis showed reduced apical global circumferential strain, suggesting possible chronic subendocardial ischemia.
The presence of calcification was distinguished from thrombus, impacting treatment decisions.

Implications:

This case highlights the utility of a multimodality imaging approach for diagnosing atypical ApHCM phenotypes.
Distinguishing calcification from thrombus is critical for preventing unnecessary anticoagulation and optimizing patient care.
Further research is needed to validate the association between ApHCM, calcification, and chronic ischemia.