title: Hypertrophic apical cardiomyopathy: a subtype of hypertrophic cardiomyopathy.
abstract: This is the first report of hypertrophic apical cardiomyopathy outside of Japan. Electrocardiographic, vectorcardiographic, echocardiographic, hemodynamic and angiographic investigations support the view that this entity is a subset of hypertrophic cardiomyopathy that differs from hypertrophic obstructive cardiomyopathy and left-ventricular cavity obliteration. The ECG recorded giant negative T waves associated with prominent R waves in the precordial leads and septal Q waves were absent, with a normal mean QRS axis in the frontal plane. The vectorcardiogram showed a QRS loop oriented to the left anteriorly and inferiorly, while the T loop was characteristically discordant, elongated and situated in the right posterior quadrant. An M-mode ECG scan along the left-ventricular long axis revealed a marked increase in both septal and posterior wall thickness and excursions toward the apex. A characteristic spadelike configuration was observed in the left ventriculogram at end-diastole. Pressure studies at rest and after ventricular ectopic beats and isoproterenol provocation revealed no significant peak systolic pressure gradient within the left ventricle. This may have certain therapeutic implications.
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D014672:Vectorcardiography; D014700:Verapamil / Q000627:therapeutic use
chemical_list: D014700:Verapamil