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Unusual chest X-ray appearances in hypertrophic cardiomyopathy
Insights
Chest X-rays in hypertrophic cardiomyopathy patients showed atypical findings, with cardiac enlargement primarily due to atrial and right ventricular dilation, not left ventricular changes.
Area of Science:
- Cardiology
- Radiology
- Pathology
Background:
- Hypertrophic cardiomyopathy (HCM) is typically characterized by left ventricular hypertrophy.
- Atypical presentations of HCM can pose diagnostic challenges.
Purpose of the Study:
- To investigate the radiological findings in patients with hypertrophic cardiomyopathy.
- To correlate chest X-ray findings with other diagnostic data in HCM.
Main Methods:
- Retrospective review of chest X-rays from 12 patients diagnosed with hypertrophic cardiomyopathy.
- Analysis of echocardiographic, angiographic, and necropsy data for correlation.
Main Results:
- Chest X-rays revealed grossly abnormal and atypical features in all 12 patients.
- Common findings included enlarged globular hearts, progressive cardiac enlargement over time, and significant left atrial enlargement.
- Cardiac enlargement was attributed to dilation of the atria and right ventricle, with no significant left ventricular dilation.
Conclusions:
- Chest X-ray findings in some hypertrophic cardiomyopathy cases can be atypical and misleading.
- Dilation of atria and right ventricle, rather than left ventricular hypertrophy, can be the primary cause of cardiac enlargement in certain HCM presentations.
Abstract:
The plain chest X-ray of 12 patients with hypertrophic cardiomyopathy were found to be grossly abnormal and atypical of this disease. Four patients presented with enlarged globular shaped hearts suggesting dilatation of all cardiac chambers. In a further four this appearance was seen to develop over a period of years and four patients were found with marked left atrial enlargement. On reviewing the echocardiographic, angiographic and necropsy data it was noted that the cardiac enlargement was produced by dilation of the atria and the right ventricle but not the left ventricle.