Apical hypertrophic cardiomyopathy associated with chronic hypertension: diagnostic and management implications.
Apical hypertrophic cardiomyopathy (HCM) is a rare variant of HCM in the non-Japanese population (1% to 2%). Diagnostic dilemma occurs when this type of HCM is newly discovered in a patient previously diagnosed with left ventricular hypertrophy (LVH) secondary to hypertension. We describe an atypical presentation of an apical HCM in the setting of chronic hypertension (HTN) and review the literature of this rare variant of HCM. Our patient presented with chest pain and was found to have apical HCM with inducible apical ischemia and an abnormal blood pressure response to exercise. Multimodality imaging approach is proposed to evaluate the LVH when both apical HCM and hypertension are present given the impact of an accurate diagnosis on prognosis and management.
Department of Internal Medicine, University of Connecticut Health Center, Farmington, USA.
Constancia
C
Macatangay
Ravi
R
Marfatia
Electra
E
Kaloudis
Erick
E
Avelar
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D001741:Black or African American; D001794:Blood Pressure; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D002637:Chest Pain / Q000209:etiology*; D002908:Chronic Disease; D019468:Disease Management; D004452:Echocardiography; D015444:Exercise; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists