The Ace of Spades: Apical Hypertrophic Cardiomyopathy in an African Male Patient

Abstract

We present a case of a 52-year-old African male patient diagnosed with apical hypertrophic cardiomyopathy. He was initially diagnosed with hypertensive heart disease and placed on anti-failure treatment. Following multiple subsequent presentations and on closer review of his signs and symptoms, apical hypertrophic cardiomyopathy was considered. The diagnosis was made five years after his initial presentation and confirmed by echocardiography and cardiac magnetic resonance imaging. This case report explores his presentation and aims to provide further literature on the aetiology, description, and management of apical hypertrophic cardiomyopathy, particularly within the African population.

High-Risk Apical Hypertrophic Cardiomyopathy Requiring an Implantable Cardioverter-Defibrillator: A Case Report of an Overlooked Etiology

“…As for our patient, we believed the presence of LGE >15% of total LV mass raised the risk for arrhythmogenic SCD and thus performed ICD placement. Indeed, as suggested by both cohort studies and case report literature, the risk of SCD in apical HCM is not negligible [ 12 - 15 ]. A recent retrospective study found that patients with apical HCM had an estimated SCD rate of 2.7% per year in their sample population, of which a personal history of unexplained syncope, non-sustained ventricular tachycardia (VT), and LGE by CMR were common risk factors noted [ 12 ].…”

“…In another case report, an African American patient had multiple admissions presumed to be primarily due to hypertensive heart disease. However, upon closer review of his ECGs and echocardiography, the authors suspected a diagnosis of apical HCM was suspected [ 15 ]. Subsequent CMR confirmed the diagnosis, revealing near-complete cavity obliteration of the LV apex and significant LGE.…”