Apical hypertrophic cardiomyopathy (AHCM) is a well-known clinical entity, which is characterized by LV apex hypertrophy and the giant negative T wave at ECG and a spade-like left ventricle. It is a uncommon morphologic variant of hypertrophic cardiomyopathy (HCM) and AHCM appears to be particularly common in Asia whose prevalence was 15% and 3% of all the HCM patients in Japan and USA, respectively. In this case, we present a dramatic progress from symmetrical left ventricular hypertrophy to AHCM with apical aneurysm.
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