title: Eccentric apical hypertrophic cardiomyopathy unmasked by multimodality imaging: an uncommon but missed cause of out of hospital cardiac arrest.
abstract: A woman in her late 50s experienced a witnessed, sudden out of hospital cardiac arrest. Initial workup included coronary angiography, transthoracic echocardiogram and a CT scan of the chest to rule out pulmonary embolus. She was subsequently discharged home without an implantable cardioverter defibrillator (ICD) or a life vest. On follow-up at another facility, an ICD was placed and a Holter monitor showed no ventricular ectopy. Further transthoracic echocardiographic images were obtained, which were suggestive of apical hypertrophic cardiomyopathy. A limited transthoracic echocardiogram with contrast was performed, which did not elucidate the hypertrophy. However, eccentric left ventricular apical wall hypertrophy was visualised by a coronary CT scan.
authors.affiliation: Department of Pediatrics and Adolescent Medicine/Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Towe
authors.affiliation: Department of Medicine/Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Medicine/Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Geske
authors.affiliation: Department of Pediatrics and Adolescent Medicine/Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ackerman
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis*; D017147:Defibrillators, Implantable; D057210:Delayed Diagnosis; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology*; D014057:Tomography, X-Ray Computed