title: [Clinical diagnosis of apical hypertrophic cardiomyopathy].
abstract: OBJECTIVE
  To evaluate the clinical features of apical hypertrophic cardiomyopathy (AHCM) and the value of ECG for a reliable clinical diagnosis as compared with two-dimensional echocardiography.
  
  
  METHODS
  29 cases with AHCM were studied by with clinical features, ECG, echocardiography, myocardial scanning, coronary angiography and left ventriculography (LVG).
  
  
  RESULTS
  The major clinical feature of AHCM was myocardial ischemia; ECG showed increased R amplitude and inverted T in chest leads. The increase of R amplitude was in such a pattern that RV(4)>or=RV(5) > RV(3). Thickening of left ventricular apical wall was found with echocardiography and radionuclide myocardial scanning. Exercise electrocardiogram showed myocardial ischemia in 20 cases. LVG and coronary angiography demonstrated apical hypertrophic cardiomyopathy with normal coronary arteries in 16 cases.
  
  
  CONCLUSIONS
  The characteristic inverted T waves and increased R wave amplitude with RV(4)>or=RV(5 > RV3) in the ECG are the important signs for clinical diagnosis of AHCM.
authors.affiliation: Cardiovascular Department, Beijing Friendship Hospital, Beijing 100050, China.
authors.forename: W
authors.initials: W
authors.lastname: Ma
authors.forename: L
authors.initials: L
authors.lastname: Shen
authors.forename: W
authors.initials: W
authors.lastname: Tian
authors.forename: Q
authors.initials: Q
authors.lastname: Zhu
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged