DR MOHAMMED IRFAN SHEIKH almost 6 years ago

Apical Hypertrophic Cardiomyopathy

A 68-year-old woman presented with symptoms of palpitations and was found to have frequent premature ventricular contractions and nonsustained ventricular tachycardia. A transthoracic echocardiogram showed possible evidence of left ventricular apical aneurysm, and a left ventriculogram was obtained (Video 1). Hypertrophic cardiomyopathy with an apical variant was seen during systole (Panel A) and diastole (Panel B) and was subsequently confirmed on cardiac magnetic resonance imaging. The patient did not have angiographic evidence of epicardial coronary artery disease. Genetic testing was not performed. She was treated with sotalol for the palpitations and received an implantable cardioverter–defibrillator (ICD) for primary prevention of sudden cardiac death. At a clinic visit 5 months later, she had received no ICD shocks and reported no symptoms of severe palpitations. The apical variant is seen more frequently in the Asian population than in the non-Asian population (which included the patient, who was white). Longitudinal cohort studies have shown that the rate of cardiac death among patients with apical hypertrophic cardiomyopathy is similar to that among patients with other forms of hypertrophic cardiomyopathy but is higher among women than among men.