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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.

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