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ECG Never Lies: A Case of Apical Hypertrophic Cardiomyopathy
Francesco Briani1, Ilaria Minnucci1
1Division of Cardiology, Mater Salutis Hospital, Legnago (Verona), Italy.
Insights
Apical hypertrophic cardiomyopathy (ApHCM) is a rare heart condition. Multimodality imaging is crucial for diagnosing ApHCM, especially when initial tests are inconclusive.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Apical hypertrophic cardiomyopathy (ApHCM) is a distinct variant of hypertrophic cardiomyopathy.
- It is characterized by significant thickening of the left ventricular apex.
Abstract:
Apical hypertrophic cardiomyopathy (ApHCM) is a less common variant of hypertrophic cardiomyopathy, characterized by predominant thickening of the left ventricular apex. We describe a 64-year-old man presenting with dyspnea and T-wave inversions in the lateral precordial leads. Although initial echocardiography was reported as normal, further imaging revealed an "ace of spades" configuration on ventriculography and an anechoic apical area on off-axis views. Contrast echocardiography confirmed apical wall thickening with systolic obliteration. Cardiac magnetic resonance imaging showed patchy late gadolinium enhancement, and Holter monitoring excluded sustained arrhythmias. This case highlights the role of multimodality imaging in ApHCM.
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