title: Echocardiography and cardiac MRI in mutation-negative hypertrophic cardiomyopathy in an older patient: a case defining the need for ICD.
abstract: We report the case of a 67-year-old man with hypertrophic cardiomyopathy who presented for a second opinion about implantable cardio-defibrillator (ICD) placement after a witnessed syncopal episode. Despite his older age, being mutation-negative, and having a maximal septal thickness of 2.2 cm on echocardiography, he demonstrated rapid progression of myocardial fibrosis on cardiac MRI, correlating to ventricular tachyarrhythmias and syncope. We review the role of echocardiography and cardiac MRI in optimizing medical care for such patients who may not otherwise meet criteria for an ICD placement or further interventions.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Fatima
authors.initials: F
authors.lastname: Rodriguez
authors.forename: Kathleen O
authors.initials: KO
authors.lastname: Degnan
authors.forename: Christine E
authors.initials: CE
authors.lastname: Seidman
authors.forename: Judy R
authors.initials: JR
authors.lastname: Mangion
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003287:Contrast Media; D017147:Defibrillators, Implantable; D004452:Echocardiography / Q000379:methods*; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009154:Mutation; D009206:Myocardium / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: cardiac MRI; echocardiography; hypertrophic cardiomyopathy