We present three patients with apical hypertrophic cardiomyopathy, their diagnosis was performed by means of imaging techniques to determine morphology, severity, configuration, complications, and distribution of the ventricular hypertrophy. Through color-flow and pulsed Doppler, the protosystolic flow in the midventricular region was detected, which we believe corresponds to the obstruction due to coarctation of the walls during early ventricular systole and that this gradient is independent from the one identified as paradoxical in patients with apical aneurysm. Explorations by means of magnetic resonance and Gated-Spect myocardial gammagraphy revealed the apical location of the hypertrophy confirming the "spadelike" configuration of the left ventricle and the absence of apical aneurysm.
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