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Apical hypertrophic cardiomyopathy presenting as acute subendocardial myocardial infarction
A A Cubukçu1, P J Scott, G J Williams
1Killingbeck Hospital, Non-invasive Unit, Leeds, UK.
Insights
Apical hypertrophic cardiomyopathy can cause angina and ECG changes mimicking heart attacks. A significant pressure gradient in the left ventricle was observed in both patients, highlighting this condition.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Apical hypertrophic cardiomyopathy (AHC) is a variant of hypertrophic cardiomyopathy.
- Patients may present with chest pain and electrocardiogram (ECG) abnormalities.
Abstract:
Two patients with apical hypertrophic cardiomyopathy presented with angina at rest and giant inverted T waves in precordial leads on the electrocardiogram. At cardiac catheterisation one patient had mild coronary artery disease, the other had normal coronary arteries. In both, there was a systolic pressure gradient between the apex and main left ventricular cavity exceeding 100 mmHg. The presence of rest angina with the electrocardiographic findings lead to a mistaken, initial diagnosis of acute subendocardial myocardial infarction.