New Concepts in Hypertrophic Cardiomyopathies, Part II

We describe a case of hypertrophic cardiomyopathy with mid-left ventricular obstruction and apical aneurysm containing thrombi where live/real time three-dimensional transthoracic echocardiography provided incremental value over two-dimensional echocardiography in assessing the findings.

Incremental value of live/real time three-dimensional transthoracic echocardiography over two-dimensional echocardiography in hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm.

https://www.internationaljournalofcardiology.com/article/S0167-5273(07)01479-9/pdf

Mid-ventricular obstructive hypertrophic cardiomyopathy with apical aneurysm: Report of 2 cases

A 29-year old male was transferred to our hospital with an abnormal chest X-ray finding diagnosed as hypertrophic cardiomyopathy with apical necrosis and aneurysm formation. Four years after the initial hospitalization, we confirmed the aneurysm and necrosis using both integrated positron emission tomography (PET) and computed tomography (CT) scanning. The F-18 2-fluoro-2-deoxy-D-glucose (FDG) PET/CT enabled precise localization of the aneurysm, which was found to be composed of semi-lunar calcification of non-metabolic myocardium. A contrast-enhanced CT angiography showed an hour-glass appearance of the left ventricular cavity. The integrated PET/CT fusion scanner is a novel multimodality technology that allows for a comprehensive analysis of the anatomical and functional status of complex heart disease. Based on these findings, long standing mechanical and physiologic abnormalities may have led to chronic ischemia in the hypertrophied myocardium, induced necrosis and calcification at the cardiac apex.

Hypertrophic cardiomyopathy complicated by left ventricular apical necrosis and aneurysm in a young man: FDG-PET findings.

Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) is a rare form of hypertrophic cardiomyopathy which often accompanies apical aneurysm. In this report, we present 2 cases of MVOHCM. Echocardiography revealed asymmetric septal hypertrophy and mid-ventricular obstruction with pressure gradient within the left ventricle and cine magnetic resonance imaging showed an apical aneurysm in both cases. © 2007 Elsevier Ireland Ltd. All rights reserved.

Letter to the Editor Mid-ventricular obstructive hypertrophic cardiomyopathy with apical aneurysm: Report of 2 cases

Three cases of patients with hypertropic cardiomyopathy, apical aneurysm, and mid-ventricular obstruction are presented. Two patients were diagnosed first by two-dimensional and Doppler echocardiography, which showed mid-ventricular obliteration, characteristic hourglass image, and paradoxic jet flow. One patient with suboptimal echocardiogram was necessary to perform contrast echocardiogram. Clinical picture was characterized by angina and dyspnea. Thallium myocardial imaging revealed perfusion abnormalities in apical region, ischemia or necrosis. Cardiac catheterism showed mid-ventricular obliteration and significant intraventricular gradient and coronary arteries angiography without lesions.

Clinical and Echocardiographic Aspects of Mid‐Ventricular Hypertrophic Cardiomyopathy

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Clinical and Echocardiographic Aspects of Mid‐Ventricular Hypertrophic Cardiomyopathy