title: Isolated Left Ventricular Apical Hypoplasia with Right Ventricular Outflow Tract Obstruction: A Rare Combination.
abstract: Isolated left ventricular (LV) apical hypoplasia is a unusual and recently recognized congenital cardiac anomaly. A 19-year-old man was found to have an abnormal ECG and cardiac murmur identified during a routine health check since joining work. His ECG revealed normal sinus rhythm, right-axis deviation, poor R wave progression, and T wave abnormalities. On physical examination, a 2/6～3/6 systolic murmur was heard at the second intercostal space along the left sternal border. Subsequent echocardiography and cardiac magnetic resonance imaging confirmed the LV apical hypoplasia. Of note, we first found that LV apical hypoplasia was accompanied by RV outflow tract obstruction due to exaggerated rightward bulging of the basal-anterior septum during systole. A close follow-up was performed for the development of heart failure, pulmonary hypertension, and potentially tachyarrhythmia.
authors.affiliation: Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
authors.forename: Yonghui
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
authors.forename: Jiaying
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
mesh_terms: D004562:Electrocardiography; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis*; D006337:Heart Murmurs / Q000209:etiology; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D008297:Male; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
keywords: hypoplasia; right ventricular outflow tract obstruction, cardiomyopathy imaging