An Unexpected Cause of Asymmetric Left Ventricular Hypertrophy

An 81-year-old woman was referred to our Cardiomyopathy Clinic for unexplained asymmetric left ventricular hypertrophy. She was asymptomatic, with no family history of cardiac disease nor of sudden cardiac death. The patient's medical history included a hepatitis C virus infection, successfully eradicated with antiviral therapy, and a hysterectomy for multiple uterine leiomyomas at the age of 36. Moreover, she underwent thoracoscopic right upper and right lower wedge resection for multiple pulmonary masses, consistent with metastatic benign leiomyomas, at the age of 63. Three years before the current evaluation, a recurrence of pulmonary leiomyomas, not affecting respiratory dynamics, nor causing any symptom, was diagnosed but not treated with surgery. Follow-up evaluations by CT scan showed slow progression of pulmonary lesions over the years in the absence of clinical manifestations.