Association of ST elevation with apical aneurysm in hypertrophic cardiomyopathy

Özeke, Özcan; Ertan, Cagatay; Keskin, Gökhan; Deveci, Bülent; Çay, Serkan; Özcan, Fırat; Topaloğlu, Serkan; Aras, Dursun; Demir, Ahmet Duran; Aydoğdu, Sinan

doi:10.1016/j.ihj.2015.05.019

Cited by 12 publications

(7 citation statements)

References 30 publications

(69 reference statements)

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“…8 ST-segment elevation in HCM is relatively rare, and the occurrence may be due to apical aneurysm (particularly in V4-V6 leads) and left ventricular hypertrophy (especially in V1-V3 leads). 9 However, HCM characterized by ST-segment elevation of the lateral wall as the main manifestation, such as this case, is very rare. In addition, extensive myocardial fibrosis may be another reason for myocardial inactivation, resulting in ST-segment elevation.…”

Section: Discussionmentioning

confidence: 85%

“…ECG abnormalities usually include abnormal P wave, Q wave (especially in the inferior and lateral leads), left axis deviation, and deeply inverted T waves in V2‐V4 leads (patients with apical HCM) 8 . ST‐segment elevation in HCM is relatively rare, and the occurrence may be due to apical aneurysm (particularly in V4–V6 leads) and left ventricular hypertrophy (especially in V1–V3 leads) 9 . However, HCM characterized by ST‐segment elevation of the lateral wall as the main manifestation, such as this case, is very rare.…”

Section: Discussionmentioning

confidence: 99%

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Hypertrophic cardiomyopathy with heart failure and ST‐segment elevation of the lateral wall

et al. 2022

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Hypertrophic cardiomyopathy (HCM) is the most common cardiovascular disease that is inherited from a single gene. Its clinical manifestations range from asymptomatic mutant gene carriers to patients with severe left ventricular effluent tract obstruction and end-stage HCM with motor restriction. In this case, we present a patient with the main presentation of heart failure and ST-segment elevation of the lateral wall, as determined by electrocardiogram. The patient was finally diagnosed with HCM because of genetic testing and the presentation of extensive myocardial fibrosis with reduced systolic function on cardiac magnetic resonance imaging. The patient's clinical findings, electrocardiogram, and cardiac magnetic resonance imaging were different from those of typical patients with HCM.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Hypertrophic cardiomyopathy with heart failure and ST‐segment elevation of the lateral wall

et al. 2022

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“…Morphologies of QRS‐complexes and T‐waves have a varied range of spectrum and progression. Large T‐waves on the lateral leads correlated with apical aneurysm formation even in absence of symptoms . The shape of QRS‐complexes differed between rS, including rSr’, in anterior leads (El‐Sherif sign), and normal, high, or reduced R‐wave amplitude .…”

Section: Discussionmentioning

confidence: 97%

Left ventricular aneurysms in hypertrophic cardiomyopathy with midventricular obstruction: A systematic review of literature

Elsheshtawy

Mahmoud

Abdelghany

et al. 2018

Pacing Clinical Electrophis

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“…Finally, all patients with apical aneurysms have been considered high-risk due to the possibility of thrombus formation, ventricular tachyarrhythmia, sudden cardiac death and perfusion defects [8]. All of the above underline the importance of early diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Apical Aneurysm in a Patient with Hypertrophic Cardiomyopathy Diagnostic and Management Dilemmas

Theodoridou¹,

Masmanidou²,

Kousidis³

et al. 2019

Cardiol Cardiovascmed

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We discuss a relatively rare case of a patient with an unclear diagnosis between hypertrophic cardiomyopathy (HCM) accompanied by left ventricular (LV) apical aneurysm and Myocardial Infraction with Non-Obstructive Coronary Arteries (MINOCA) associated with an LV apical aneurysm. A 77-year-old white Caucasian woman presented to a district hospital with angina-like symptoms and elevated high-sensitivity (HS) troponin I. Three weeks later, the patient was re-evaluated with heart failure (New York Heart Association -NYHA-class III) symptoms, particularly fatigue and dyspnoea in less than ordinary activity. To establish the diagnosis an echocardiogram was recommended and it revealed an LV apical aneurysm and concentric LV hypertrophy with a moderately reduced left ventricular ejection fraction (LVEF). Coronary angiography revealed absence of significant obstructive coronary artery disease. To further clarify LV hypertrophy, Cardiac Magnetic Resonance Imaging (CMR) was performed and documented LV apical aneurysm with apical transmural post-infarction fibrosis together with specific patchy myocardial fibrosis of the basal interventricular septum, indicative of hypertrophic cardiomyopathy. The diagnosis of MINOCA in a patient with hypertrophic cardiomyopathy was then established and conservative treatment with dual antiplatelet therapy (aspirin, clopidogrel), ramipril, carvedilol, eplerenone and atorvastatin was offered.

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Association of ST elevation with apical aneurysm in hypertrophic cardiomyopathy

Abstract: Clinicians and specifically echocardiographers must pay special attention on the electrocardiography to correctly detect the frequently overlooked apical aneurysm in HCM patients, and should be careful for apical aneurysm particularly in the presence of STE in V4-6 derivations.

Cited by 12 publications

References 30 publications

Hypertrophic cardiomyopathy with heart failure and ST‐segment elevation of the lateral wall

Hypertrophic cardiomyopathy with heart failure and ST‐segment elevation of the lateral wall

Left ventricular aneurysms in hypertrophic cardiomyopathy with midventricular obstruction: A systematic review of literature

Left Ventricular Apical Aneurysm in a Patient with Hypertrophic Cardiomyopathy Diagnostic and Management Dilemmas

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