title: Apical hypertrophic cardiomyopathy might lead to misdiagnosis of ischaemic heart disease.
abstract: OBJECTIVE
  In this study, demographic, clinic, electrocardiographic and angiographic properties of patients, on whom coronary angiography was performed with the pre-diagnosis of coronary artery disease (CAD) and whose ventriculography demonstrated typical apical hypertrophic cardiomyopathy (AHCM), were investigated.
  
  
  METHODS
  Seventeen patients (mean age 58 +/- 10 years, 10 male) with CAD pre-diagnosis, on whom coronary angiography was performed and had typical spade-like appearance on left ventriculography, were included in the study between January 2000 and May 2005.
  
  
  RESULTS
  As risk factor for CAD, 8 (47%) patients had hypertension, 8 (47%) patients had dyslipidaemia, 2 (11%) patients had type 2 diabetes mellitus, 13 (77%) patients had a history of smoking, and 2 (11%) patients had family history. Seven (42%) patients presented unstable angina pectoris, 8 (47%) patients presented stable angina pectoris and 2 (11%) patients were asymptomatic. On coronary angiography, it was determined that 10 (58%) patients had normal coronary arteries, 3 (17%) patients had non-significant stenosis and 4 (25%) patients had myocardial bridging. Five (30%) patients revealed mid-ventricular obstruction and intraventricular gradient was 25 +/- 5 mmHg by the catheterization. All patients showed ''giant'' negative (> or = 10 mm) T waves in the precordial leads, whereas 2 patients had atrial fibrillation. Maximum wall thickness was measured as 18 +/- 4 mm in the apical region by transthoracic echocardiography. One patient (5%) who had mid-ventricular obstruction developed atrial fibrillation during 2 years follow-up, though any other events did not occur during hospitalization or follow-up period.
  
  
  CONCLUSIONS
  Physicians caring for patients with chest pain should consider AHCM in their differential diagnosis in case of a patient with chest pain and electrocardiographic changes suggestive of CAD.
authors: Department of Cardiology, Ege University Medical Faculty, Bornova, Izmir 35100, Turkey. hamzakard@yahoo.com
authors: Hamza
authors: H
authors: Duygu
authors: Mehdi
authors: M
authors: Zoghi
authors: Sanem
authors: S
authors: Nalbantgil
authors: Filiz
authors: F
authors: Ozerkan
authors: Azem
authors: A
authors: Akilli
authors: Mustafa
authors: M
authors: Akin
authors: Remzi
authors: R
authors: Onder
authors: Umit
authors: U
authors: Erturk
mesh_terms: D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis*; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004452:Echocardiography; D015150:Echocardiography, Doppler; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D015635:Radionuclide Ventriculography; D012189:Retrospective Studies; D012307:Risk Factors