title: Progressive breathlessness in an Afro Caribbean hypertensive subject.
abstract: The sensitivity and specificity of structural assessment of the heart by echocardiography in  black hypertensive patients presenting with symptoms of heart failure is often incomplete.  Cardiovascular magnetic resonance, mainly by virtue of its ability to characterize myocardial  tissue composition, may be of value in differentiating some of the common pathologies  noninvasively. We present an illustrative case of hypertrophic cardiomyopathy in a British  Afro Caribbean hypertensive patient where at least some features of familial amyloidosis were  present on screening echocardiography. Cardiovascular magnetic resonance examination of  this case established not only the usefulness of this technique, but also highlighted the importance  of recognizing the variations and departure from the usual which one associates with hypertrophic  cardiomyopathy, so as to arrive at the final diagnosis.
authors.affiliation: University of Birmingham, Birmingham, UK. g.dwivedi@bham.ac.uk
authors.forename: Girish
authors.initials: G
authors.lastname: Dwivedi
authors.forename: Robert J
authors.initials: RJ
authors.lastname: MacFadyen
authors.forename: Chetan
authors.initials: C
authors.lastname: Varma
authors.forename: Vishal
authors.initials: V
authors.lastname: Sharma
authors.forename: Desley
authors.initials: D
authors.lastname: Neil
authors.forename: Richard P
authors.initials: RP
authors.lastname: Steeds
mesh_terms: D044383:Black People; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology; D017691:Caribbean Region; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D004452:Echocardiography; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000208:ethnology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity