Apical hypertrophic cardiomyopathy and atrial septal defect: part of a multi-organ syndrome?
OBJECTIVE
We describe a case of non-obstructive apical hypertrophic cardiomyopathy with atrial septal defect, in a 48-year-old caucasian female patient with chronic renal failure, hypothyroidism and primary amenorrhea, referred to our hospital for syncope, palpitation and shortness of breath.


RESULTS
Electrocardiogram, transthoracic echocardiogram and cardiac magnetic resonance showed classical features of apical hypertrophic cardiomyopathy. Apical hypertrophic cardiomyopathy is morphologically characterized by apical ventricular hypertrophy, and is reported to be a relatively benign prognosis compared with the other type of hypertrophic cardiomyopathy.


CONCLUSIONS
Apical hypertrophic cardiomyopathy is very rare in the West, is occasionally encountered in Japanese persons, but there have been only a few reports of its coexistence with atrial septal defect. Our present report is the first case of apical hypertrophic cardiomyopathy with atrial septal defect associated with renal failure, hypothyroidism and primary amenorrhea that could represent a multi-organ syndrome. This hypothesis was supported by the finding of the same characteristics in a sister of the patient.
Department of Internal Medicine, Nephrology and Health Sciences, University of Parma, Via Gramsci 14, 43100 Parma, Italy. pattopaolo@libero.it
Paolo
P
Pattoneri
Giovanna
G
Pelà
Ettore
E
Astorri
Alberico
A
Borghetti
D000568:Amenorrhea; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007037:Hypothyroidism; D007676:Kidney Failure, Chronic; D008875:Middle Aged; D013577:Syndrome