Apical hypertrophic cardiomyopathy might lead to misdiagnosis of ischaemic heart disease

Duygu, Hamza; Zoghi, Mehdi; Nalbantgil, Sanem; Özerkan, Filiz; Akilli, Azem; Akın, Mustafa; Önder, Remzi; Ertürk, Ümit

doi:10.1007/s10554-008-9311-7

Cited by 26 publications

(25 citation statements)

References 16 publications

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“…mean maximum apical wall thichness was 18 mm in seventeen patients. 7 The study of Kitaoka et al demonstrated that wall thickness at the apex was greater in American patients than in the Japanese patients (23±4 vs. 18±2 mm, respectively).…”

Section: Discussionmentioning

confidence: 96%

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Apical Variant of Hypertrophic Cardiomyopathy Presenting as Recurrent Syncope and Wide Complex Tachycardia

et al. 2017

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Section: Discussionmentioning

confidence: 96%

“…7 Paroxysmal supraventricular tachycardia and recurrent atrial flutter are also seen in patients with HCM. 8 Although rare, ventricular tachycardia and sudden death are reported in cases with AHC.…”

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Apical Variant of Hypertrophic Cardiomyopathy Presenting as Recurrent Syncope and Wide Complex Tachycardia

et al. 2017

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“…3 Apical HC can mimic other conditions, including apical cardiac tumors, LV apical thrombus, endomyocardial fibrosis and coronary artery disease. [4][5][6][7] Patients with apical HC can be symptomatic and asymptomatic. Verapamil, beta-blockers and anti-arrhythmic agents are used in symptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

“…3 Apikalni tumori, trombi u lijevoj klijetki kao i endomiokardijalna fibroza te koronarna bolest srca mogu imitirati ovu bolest. [4][5][6][7] Bolesnici s apikalnom hipertrofijom mogu biti simptomatski i asimptomatski. Verapamil, beta-blokatori i antiaritmici mogu se koristiti u lijeËenju simptomatskih bolesnika.…”

Section: Diskusija I Zakljuëakunclassified

Apical hypertrophic cardiomyopathy: a case report

Biočić¹,

Vincelj²,

Djurasevic³

et al. 2013

Cardiol Croat.

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Pedesetosmogodiπnji bolesnik s otprije poznatom arterijskom hipertenzijom i tumorom nadbubreaene aelijezde hospitaliziran je u KliniËkoj bolnici Dubrava, Zagreb zbog bolova u prsima koji su imponirali kao stenokardija te osjeÊaja nepravilnog srËanog rada. Obiteljska anamneza je bila negativna s obzirom na iznenadnu srËanu smrt, kardiomiopatije ili srËano zatajivanje. Viπeslojnom kompjuteriziranom tomografijom bubrega i nadbubreaenih aelijezda verificirao se hormonski neaktivan adenom lijeve nadbubreaene aelijezde. Fizikalni nalaz je bio u granicama normale, kao i srËani biomarkeri te Rtg srca i pluÊa. Dominanatan nalaz u EKG-u su bili duboko negativni T-valovi u prekordijskim odvodima (Slika 1) koji su se pratili untrag 10 godina zbog Ëega je bila uËinjena i koronarografija koja je bila uredna. U ranijim nalazima transtorakalne ehokardiografije (TTE) opisivana je koncentriËna hipertrofijska kar- SAAEETAK: Apikalna hipertrofijska kardiomiopatija (AHK) predstavlja rijetku varijantu hipertrofijske kardiomiopatije koju karakterizira zadebljanje najdistalnijeg dijela stijenke lijevog ventrikula. Prvi put ju je opisao Sakamoto 1976. godine u Japanu. U radu Yamaguchi i sur. AHK opisana je kao zapanjujuÊi elektrokardiografski zapis u vidu negativnih T-valova u prekordijalnim odvodima te ventrikulografijom prikazana lijeva klijetka koja podsjeÊa na "as pika". Iako je ovaj entitet ËeπÊi u Aziji i Ëini oko 13% do 25% ukupnih hipertrofijskih kardiomiopatija, takoer je opisan i u zapadnim zemljama, ali sa znatno manjom prevalencijom. Za dijagnozu AHK koristimo EKG, ehokardiografiju, ventrikulografiju, nuklearnu perfuziju srca i magnetsku rezonanciju srca.Prikazujemo 58-godiπnjeg bolesnika kod kojeg je AHK bila neprepoznata deset godina. ZakljuËno, i u hrvatskoj populaciji moaeemo naiÊi na ovu rijetku varijantu hipertrofijske kardiomiopatije, a pravilna interpretacija EKG i ehokardiografije ukazuje na ovaj rijedak entitet. KLJU»NE RIJE»I: apikalna hipertrofijska kardiomiopatija, abnormalan EKG, ehokardiografija SUMMARY: Apical hypertrophic cardiomyopathy (AHC) is a rare variant of hypertrophic cardiomyopathy characterized by thickening of the most distal part of the left ventricular (LV) wall. It was first described by Sakamoto in 1976 in Japanese patients. AHC was reported as a striking electrocardiographic pattern of giant negative T-waves and angiographic feature of end diastolic LV cavity configuration resembling an ace of spade by Yamaguchi et al. Although AHC is more common in Asia and it accounts for about 13% to 25% of all cases of hypertrophic cardiomyopathy, it is much less prevalent in the western population. Diagnostic modalities include ECG, echocardiography, ventriculography, nuclear myocardial perfusion studies and cardiac magnetic resonance imaging. We present a 58-year-old man with AHC that was unrecognized for the previous 10 years. In conclusion, this rare disease could be found in the Croatian population too, whereas the appropriate interpretation of the ECG and echocardiography is crucial in recognizing ...

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“…AHCM may mimic other conditions, including apical cardiac tumors [10] , LV apical thrombus [11] , isolated ventricular non-compaction [12] , endomyocardial fibrosis (EMF) [13] and coronary artery disease [14] ( Table 1). Chest pain in a patient with AHCM can be mistaken for ischemia from coronary artery disease [14] .…”

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Apical hypertrophic cardiomyopathy

Yusuf

Bathina²,

Banchs³

et al. 2011

WJC

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We describe a patient with asymptomatic apical hypertrophic cardiomyopathy (AHCM) who later developed cardiac arrhythmias, and briefly discuss the diagnostic modalities, differential diagnosis and treatment option for this condition. AHCM is a rare form of hypertrophic cardiomyopathy which classically involves the apex of the left ventricle. AHCM can be an incidental finding, or patients may present with chest pain, palpitations, dyspnea, syncope, atrial fibrillation, myocardial infarction, embolic events, ventricular fibrillation and congestive heart failure. AHCM is frequently sporadic, but autosomal dominant inheritance has been reported in few families. The most frequent and classic electrocardiogram findings are giant negative T-waves in the precordial leads which are found in the majority of the patients followed by left ventricular (LV) hypertrophy. A transthoracic echocardiogram is the initial diagnostic tool in the evaluation of ACHM and shows hypertrophy of the LV apex. AHCM may mimic other conditions such as LV apical cardiac tumors, LV apical thrombus, isolated ventricular non-compaction, endomyocardial fibrosis and coronary artery disease. Other modalities, including left ventriculography, multislice spiral computed tomography, and cardiac magnetic resonance imagings are also valuable tools and are frequently used to differentiate AHCH from other conditions. Medications used to treat symptomatic patients with AHCM include verapamil, beta-blockers and antiarrhythmic agents such as amiodarone and procainamide. An implantable cardioverter defibrillator is recommended for high risk patients.

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Apical hypertrophic cardiomyopathy might lead to misdiagnosis of ischaemic heart disease

Abstract: Physicians caring for patients with chest pain should consider AHCM in their differential diagnosis in case of a patient with chest pain and electrocardiographic changes suggestive of CAD.

Cited by 26 publications

References 16 publications

Apical Variant of Hypertrophic Cardiomyopathy Presenting as Recurrent Syncope and Wide Complex Tachycardia

Apical Variant of Hypertrophic Cardiomyopathy Presenting as Recurrent Syncope and Wide Complex Tachycardia

Apical hypertrophic cardiomyopathy: a case report

Apical hypertrophic cardiomyopathy

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