Open AccessSevere midventricular hypertrophic obstructive cardiomyopathy and apical aneurysm
Author(s) -
G Gibelli,
Salvatore Biasi,
Valeria Buonamici
Publication year - 2013
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/2211-4122.123954
Subject(s) - hypertrophic cardiomyopathy , medicine , cardiology , apex (geometry) , diastole , aneurysm , magnetic resonance imaging , heart aneurysm , blood flow , radiology , anatomy , blood pressure
A 40-year-old man was found to have hypertrophic cardiomyopathy (HCM) with severe mid ventricular obstruction. The obstruction produced two distinct left ventricular chambers with an estimated 60 mmHg continuous wave (CW) Doppler intraventricular gradient. Pulsed wave (PW) Doppler showed high velocity systodiastolic flow from apex to base and flow from base to apex confined mostly to the second half of diastole. Cardiac magnetic resonance (CMR) showed midventricular obstruction, due to septal, parietal, and to an hypertrophic, double posteromedial papillary muscle; an apical aneurysm was detected. Aneurysm is underdiagnosed by echocardiography in HCM and an accurate anatomic definition is needed if surgery is planned; thus, a CMR should always be obtained in these patients.