[Possible pathogenesis of giant negative T and negative U waves in hypertrophic cardiomyopathy: a report of two cases].
Giant negative T (GNT) and negative U (NU) waves are electrocardiographic findings which have been frequently observed in hypertrophic cardiomyopathy (HCM). Here we report 2 cases. For the first patient, electrocardiographic and left ventriculographic studies before and after the development of GNT and NU waves and left ventricular high voltage during the follow-up period were performed. For the second patient, electrocardiographic and echocardiographic findings were obtained before and after onset of posterior myocardial infarction. In the first patient, posterior papillary muscle hypertrophy was evident on left ventriculography after appearance of GNT and NU waves. In the second patient, both GNT and NU waves disappeared after posterior myocardial infarction. Two-dimensional echocardiograms demonstrated akinesis in the posterior wall, including the posterior papillary muscle, after 8 weeks of posterior infarction. Therefore, we suggest that apical hypertrophy, especially of the posterior papillary muscle, may play an important role in the pathogenesis of GNT and NU waves in HCM.
Hasegawa
K
K
Department of Medicine, Kawasaki Medical School, Kurashiki.
Sawayama
T
T
Nezuo
S
S
Tadaoka
S
S
Kawahara
Y
Y
Inoue
S
S
D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D010210:Papillary Muscles / Q000473:pathology; D011859:Radiography