Apical hypertrophic cardiomyopathy (HCM) is a rare variant of HCM in the non-Japanese population (1% to 2%). Diagnostic dilemma occurs when this type of HCM is newly discovered in a patient previously diagnosed with left ventricular hypertrophy (LVH) secondary to hypertension. We describe an atypical presentation of an apical HCM in the setting of chronic hypertension (HTN) and review the literature of this rare variant of HCM. Our patient presented with chest pain and was found to have apical HCM with inducible apical ischemia and an abnormal blood pressure response to exercise. Multimodality imaging approach is proposed to evaluate the LVH when both apical HCM and hypertension are present given the impact of an accurate diagnosis on prognosis and management.
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Article Synopsis
- Hypertrophic cardiomyopathy (HCM) is a heart condition where the heart muscle thickens, with apical HCM being a rarer form that affects specific regions of the heart.
- Traditional echocardiography can make diagnosing apical HCM difficult, leading to cases where patients are referred for CT coronary angiography.
- The study presents four cases where CT scans not only ruled out coronary artery disease but also helped confirm apical HCM through detailed evaluation of the CT data.
Article Synopsis
- * A study analyzed 21 individuals with ALPK3tv, revealing they typically present symptoms at an older age (average 57.25 years) and exhibit less severe heart thickening compared to 132 control patients with other HCM-related genetic variants.
- * ALPK3tv patients show a lower occurrence of obstructive HCM and a higher rate of apical aneurysms, suggesting milder hypertrophy but an increased risk for arr
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