Apical variant hypertrophic cardiomyopathy “multimodality imaging evaluation”

Huang, Gary; Fadl, Shaimaa Abdelhassib; Sukhotski, Stan; Matesan, Manuela

doi:10.1007/s10554-019-01739-x

Cited by 18 publications

(23 citation statements)

References 55 publications

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“…Apical hypertrophic cardiomyopathy is described as having an end‐diastolic apical thickness of >15 mm and an apico‐basal ratio of wall thickness of >1.3‐1.5 4,9,11,12 . However, as the apical cap is the thinnest segment of the entire LV, the threshold of wall thickness may be less in the presence of the accompanying findings 2,13 . The apical thickness should be assessed carefully as foreshortening of LV could lead to an overdiagnosis by creating a falsely thickened apex 14 .…”

Section: Echocardiography Of Aphcm and Adpmmentioning

confidence: 99%

“…Obstruction is usually detected at the mid‐ventricular level and not in the LVOT in patients with ApHCM, as the basal segments of the LV are usually spared. Thus, in cases with pure ApHCM, LVOTO is not expected 11,13,22 . Hypertrophy involving the mid‐ventricular segments can typically result in mid‐ventricular obstruction (MVO) due to cavity obliteration.…”

Section: Echocardiography Of Aphcm and Adpmmentioning

confidence: 99%

“…However, nuclear imaging is not recommended if the only aim is cardiac anatomy evaluation 10 . On the other hand, as patients with ApHCM have marked T‐wave inversion and chest pain, they are often referred for myocardial perfusion imaging (MPI) to exclude ischemia and there are typical perfusion patterns of ApHCM by MPI 13 . One of these patterns is significant increased apical tracer uptake, a spade‐like deformity of the LV, and "Solar Polar" map on myocardial perfusion SPECT 50 .…”

Section: Nuclear Imaging Of Aphcm and Adpmmentioning

confidence: 99%

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Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view

et al. 2020

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Apical hypertrophic cardiomyopathy (ApHCM) and apical displacement of papillary muscles (ADPM) are two different pathologies with a number of similar imaging findings that may hamper adequate diagnosis. While ApHCM is associated with increased rate of mortality, ADPM commonly presents with a benign course and differential diagnosis is of great importance. Clinical assessment and 2D echocardiography cannot sufficiently differentiate these conditions, however, and advanced echocardiographic methods may facilitate diagnosis. Although echocardiography is the first‐line imaging method in the diagnostic algorithm, cardiac magnetic resonance imaging (CMRI) is the gold standard for evaluating patients due to good spatial resolution and myocardial tissue characterization abilities. When CMRI is contraindicated, cardiac computed tomography may be an alternative reliable method that can also give information about the coronary anatomy. Nuclear imaging may also provide supplementary data regarding hypertrophy and coronary arteries when there is a suspicion of ischemia.

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Section: Echocardiography Of Aphcm and Adpmmentioning

confidence: 99%

Section: Echocardiography Of Aphcm and Adpmmentioning

confidence: 99%

Section: Nuclear Imaging Of Aphcm and Adpmmentioning

confidence: 99%

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Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view

et al. 2020

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“…basic functional evaluation. In a multi-modality imaging evaluation Huang et al found CT to be useful in the workup of hypertrophic cardiomyopathy for the exclusion of CAD and for functional information [109]. Arow et al used CT as a true 3D assessment of myocardial crypts in the differential diagnosis of myocardial hypertrophy.…”

Section: Tumor Thrombus and Infectionmentioning

confidence: 99%

Cardiovascular imaging 2019 in the International Journal of Cardiovascular Imaging

Reiber

Pereira

Dallan

et al. 2020

Int J Cardiovasc Imaging

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“…Apical hypertrophic cardiomyopathy is mainly diagnosed through electrocardiographic speci c changes combined with cardiac color Doppler ultrasound or cardiac magnetic resonance. The electrocardiogram shows a characteristic huge negative T wave, and the color Doppler ultrasound shows a left ventricular apical and end-diastolic apical wall thickness ≥15mm, and the ratio of the maximum apical wall thickness to the left ventricular posterior wall thickness≥1.3 [19]. Cardiac magnetic resonance(CMR) can determine myocardial hypertrophy segments more clearly than cardiac color Doppler ultrasound ; accordingly it is the gold standard for the diagnosis of apical hypertrophic cardiomyopathy.…”

Section: Inspiration From the Diagnosis And Treatment Of This Casementioning

confidence: 99%

Tuberous Sclerosis Complex in Children with Apical Hypertrophic Cardiomyopathy as the First Manifestation: A Case Report and Literature Review

Han

Wen

et al. 2020

Preprint

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Background: Tuberous sclerosis complex (TSC) is a rare autosomal dominant hereditary neurodermal syndrome with diverse clinical manifestations, implicating multiple organs including the nervous system, skin, kidney, lung, heart, eyes and others. Most of the children are first diagnosed with seizures or facial hemangiofibroma, 45% to 60% of patients with TSC lesions can affect the heart resulting in cardiac rhabdomyoma. Although most cardiac rhabdomyomas are asymptomatic, some children may develop severe symptoms such as hemodynamic abnormalities, arrhythmias, and even heart failure in the neonatal period and early infancy. But Tuberous sclerosis complex with apical hypertrophic cardiomyopathy as the first manifestation is rare. Hence, physicians may delay diagnosis and treatment of TSC due to the lack of comprehensive thinking on this atypical presentation.Case presentation A 5-year-old girl was admitted to our hospital due to syncope for more than 10 days. When she was 8 months old, she was diagnosed with hypertrophic cardiomyopathy and received long-term oral propranolol treatment. After her admission, a thorough examination was performed. Heart exam revealed the revelant problem. Brain MRI demonstrated mutiple nodules in bilateral frontal parietal occipital cortex, subcortical cortex and bilateral lateral ventricular margin consistent with TSC. Genetic analysis (high-precision clinical display PLUS, JiaJian Medicine Company) revealed that the patient had inherited the TSC2 mutation c.1343T> C (p.L448P) from her mother (heterozygous), who was clinically unaffected.Conclusions: This report highlights that TSC occurs in different ways. Given the possibility of insidious and atypical tuberous sclerosis, when apical hypertrophy or cardiac tumors are identified, it is recommended to broaden the systemic examination even including genetic testing to further determine the cause, in order to reduce the misdiagnosis rate of tuberous sclerosis.

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Apical variant hypertrophic cardiomyopathy “multimodality imaging evaluation”

Cited by 18 publications

References 55 publications

Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view

Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view

Cardiovascular imaging 2019 in the International Journal of Cardiovascular Imaging

Tuberous Sclerosis Complex in Children with Apical Hypertrophic Cardiomyopathy as the First Manifestation: A Case Report and Literature Review

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