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Sobreposición fenotípica en la miocardiopatía hipertrófica apical: no hay una talla única para todos
Offdan Narvaez-Guerra1, Mina Botros2, Evan Offord2
1Division of Cardiology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA offdannarvaez@gmail.com.
BMJ case reports
|August 27, 2025
Resumen
Este caso pone de relieve cómo la imagen multimodalidad es crucial para el manejo de la miocardiopatía hipertrófica (MCH) con fenotipos superpuestos. La ecocardiografía y la resonancia magnética cardíaca (CMR) pueden revelar marcadores subclínicos de pronóstico adverso en la CMH apical (ApHCM).
Área de la Ciencia:
- Cardiología
- Imágenes médicas
- La genética
Sus antecedentes:
- La miocardiopatía hipertrófica (CMH) presenta diversos fenotipos de hipertrofia ventricular izquierda, cada uno con distintos riesgos de morbilidad y mortalidad.
- Existe una superposición fenotípica entre la CMH apical (ApHCM) y la CMH ventricular media, lo que complica la estratificación del riesgo.
- El diagnóstico preciso y la evaluación del riesgo son vitales para el manejo de los pacientes con CMH.
Objetivo del estudio:
- Para ilustrar la importancia de las imágenes multimodales en un caso de superposición fenotípica de ApHCM.
- Demostrar las funciones complementarias de la ecocardiografía y la resonancia magnética cardíaca (RMC) en la evaluación del riesgo de muerte súbita cardíaca.
- Para resaltar los marcadores subclínicos de pronóstico adverso en ApHCM.
Principales métodos:
- Informe de caso de una mujer joven con superposición de ApHCM.
- Utilizó imágenes multimodales, incluida la ecocardiografía y la RMC.
- Análisis de los resultados de las imágenes para la estratificación del riesgo y los indicadores de pronóstico.
Principales resultados:
- Las imágenes multimodales identificaron una ApHCM fenotípicamente superpuesta con un riesgo variado de muerte súbita cardíaca.
- Los hallazgos ecocardiográficos y CMR sirvieron como marcadores subclínicos del pronóstico adverso.
- El caso subraya el valor diagnóstico y pronóstico de los enfoques de imágenes integradas.
Conclusiones:
- La imagen multimodalidad es esencial para el manejo de pacientes con CMH con superposición fenotípica.
- La ecocardiografía y la RMC proporcionan información crítica sobre el pronóstico de la MAPH.
- La comprensión de los fenotipos de imágenes ayuda en la evaluación personalizada del riesgo y las estrategias de gestión para la CMH.
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