[Diagnosis of apical hypertrophic cardiomyopathy using contrast echocardiography]

Comprehensive multidetector CT assessment of apical hypertrophic cardiomyopathy

16-slice multidetector CT (MDCT) cardiac findings of a middle-aged man with known apical hypertrophic cardiomyopathy (AHC) and recent atypical chest pain are presented. MDCT enabled comprehensive evaluation of the coronary arteries, diagnosing myocardial bridging of the left anterior descending (LAD) and first diagonal arteries. It also enabled dynamic evaluation of myocardial thickness and left ventricular global and regional function. This case illustrates the full capabilities of MDCT in the evaluation of AHC.

Contrast-Enhanced Echocardiography for the Diagnosis of Apical Hypertrophic Cardiomyopathy

The echocardiographic diagnosis of apical hypertrophic cardiomyopathy can be difficult in patients with poor acoustic windows. However, contrast-enhanced echocardiography can provide better images in these patients and lead to the correct diagnosis. We present a patient with apical hypertrophic cardiomyopathy who was diagnosed using contrast-enhanced echocardiography. The use of contrast-enhanced echocardiography for the diagnosis of apical hypertrophic cardiomyopathy in patients with poor acoustic windows is discussed and the experience in the literature reviewed.

Detection of apical hypertrophic cardiomyopathy by cardiovascular magnetic resonance in patients with non-diagnostic echocardiography

OBJECTIVE

To investigate the role of cardiovascular magnetic resonance (CMR) in a series of patients with ECG repolarisation changes and normal echocardiography.

PATIENTS AND DESIGN

10 patients with anterolateral T wave inversion for which there was no obvious pathological cause who had normal routine echocardiography without contrast for the exclusion of hypertrophic cardiomyopathy (HCM) also had CMR that was diagnostic of apical HCM.

RESULTS

Apical HCM detected by CMR could be morphologically severe with wall thickness up to 28 mm, or mild. The extent of repolarisation abnormalities did not correlate to the morphological severity.

CONCLUSIONS

In patients with unexplained repolarisation abnormalities, a normal routine echocardiogram without contrast does not exclude apical HCM. Further imaging with CMR or contrast echocardiography may be required. The reliance on routine echocardiography to exclude apical HCM may have led to underreporting of this condition.