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Related Experiment Videos

[Circumscribed apical left ventricular hypertrophy. Dynamic development and long term progression]

M Honcamp1, T Stein, M Stellwaag

  • 1Abteilung Kardiologie, Deutsche Klinik für Diagnostik, Wiesbaden.

Deutsche Medizinische Wochenschrift (1946)
|September 18, 1998
PubMed
Summary
This summary is machine-generated.

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This study highlights circumscribed apical left ventricular hypertrophy (ALVH), a condition that can develop significantly over time. Marked T wave negativity on ECG warrants consideration of ALVH, even with prior normal angiography.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Clinical Diagnostics

Background:

  • A 64-year-old obese male presented with a 15-year history of exercise-independent retrosternal pressure radiating to the neck and back.
  • Initial coronary angiography was negative, but resting ECG showed T wave negativity in left precordial leads.

Observation:

  • Current ECG revealed deeply inverted T waves in left precordial and limb leads with a positive Sokolow-Lyon index.
  • Left ventricular angiography demonstrated a circumscribed, "ace of spade" shaped myocardial hypertrophy limited to the apex.

Findings:

  • Diagnosis of circumscribed apical left ventricular hypertrophy (ALVH) was confirmed via left-heart catheterization and angiocardiography.
  • The patient had minor symptoms and received no treatment.

Related Experiment Videos

Implications:

  • Circumscribed ALVH can exhibit dynamic changes over long-term observation.
  • Marked T wave negativity, even with normal prior LV angiography, necessitates considering ALVH in differential diagnoses.
  • Patients with atypical angina and evolving ECG changes, despite negative coronary angiography, should undergo echocardiography focusing on LV apical muscular changes.