title: An overlooked diagnosis on transthoracic echocardiography: apical hypertrophic cardiomyopathy.
abstract: Apical hypertrophic cardiomyopathy (HCM) may be overlooked during routine echocardiography. A 54-year-old male patient with dyslipidemia and positive family history presented with atypical chest pain. The 12-lead electrocardiogram showed increased QRS voltage and deep T-wave inversions in precordial leads. Transthoracic echocardiography performed with poor echocardiographic windows demonstrated normal findings. Coronary angiography showed normal coronary arteries. Left ventriculography revealed a spade-like deformity (ace of spades), typical for apical HCM. Cardiac magnetic resonance imaging confirmed the diagnosis.
authors.affiliation: Department of Cardiology, Haydarpaşa Training Hospital, Gülhane Military Medical Academy, Istanbul, Turkey. oyiginer@yahoo.com
authors.forename: Omer
authors.initials: O
authors.lastname: Yiğiner
authors.forename: Bekir Yilmaz
authors.initials: BY
authors.lastname: Cingözbay
authors.forename: Omer
authors.initials: O
authors.lastname: Uz
authors.forename: Bekir Sitki
authors.initials: BS
authors.lastname: Cebeci
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume