Complete systolic obliteration of the left ventricle due to an apical hypertrophic cardiomyopathy in a totally asymptomatic patient.
2013
A 30-years-old man, subjected to an electrocardiogram for screening, showed signs of
left ventricular hypertrophyand “giant” inverted
T-wavesin pre-cordial leads. So, a
transthoracic echocardiogramand a Coronary angiography were performed that showed first, a normal ventricular function and second, normal coronary arteries. Luckily, we associated to the Coronary angiography a Ventriculography that revealed a marked hypertrophy particularly in the apex and a 90% complete tele-systolic obliteration of the left ventricle. To better address our diagnosis, we performed a cardiac magnetic resonance that confirmed the Apical
Hypertrophic Cardiomyopathy(AHCM) involving concentrically the apex known as “spade-like configuration” and an apical akinesia with
slow-flow. Since the patient was totally asymptomatic, he was discharged without any treatment. AHCM is a form of
Hypertrophic Cardiomyopathy(HCM) with an hypertrophy of the left ventricular apex. This disease is often sporadic and among the forms of HCM it has a benign prognosis although in > 50% of patients AHCM is symptomatic with chest pain and
palpitations. Our patient incredibly never had cardiac symptoms and was always in a good health state, so only thanks to the association of Ventriculography to the Coronary angiography we were able to reach this unusual diagnosis.
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