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The identification of high-risk patients with hypertrophic cardiomyopathy (HC) for primary  prevention of sudden cardiac death (SCD) remains a challenging issue, since major risk  factors sometimes lack specificity. We report the case of a patient with HC and association of  apical aneurysm and myocardial bridging who had been initially not implanted because she  had only one major risk factor. She subsequently experienced a sustained ventricular tachycardia  that finally motivated the implantation. We conclude that it is never an easy decision to  implant a preventive implantable cardioverter-defibrillator (ICD). Nevertheless, additional  criteria for a better selection of patients who would benefit from an ICD implant are certainly  useful.

Apical aneurism and myocardial bridging in a patient with hypertrophic cardiomyopathy: Association or consequence of the myocardial bridging?