Apical Hypertrophic Cardiomyopathy: The Ace-of-Spades as the Disease Card.
Apical cardiac hypertrophy (Yamaguchi syndrome) is a relatively rare form of hypertrophic cardiomyopathy. A 67-year-old woman presented with exertional angina and moderate dyspnea. Her electrocardiogram showed sinus rhythm, flattened T waves in the limb leads and a strain pattern in the V2-V6 leads. Echocardiographic examination showed that apical wall thickness of the left ventricle (LV) was 19 mm. Coronary angiography was normal, but left ventriculography revealed a spade-like shaped LV cavity, typical for apical cardiac hypertrophy. The diagnostic criteria for apical cardiac hypertrophy are: 1) asymmetric LV hypertrophy - predominantly at the apex of the ventricle; 2) LV wall thickness of 15 mm or more during diastole; and 3) apical to posterior wall thickness ratio of 1.5 or more determined by 2-dimensional echocardiography or cardiac magnetic resonance imaging. Although relatively rare, Yamaguchi syndrome must enter into the differential diagnosis of patients presenting with exertional angina pectoris.


BACKGROUND
Angina pectoris; Hypertrophic cardiomyopathy.
University of Medicine and Pharmacy, Carol Davila, Internal Medicine Clinic;
Camelia C
CC
Diaconu
Internal Medicine Clinic, Clinical Emergency Hospital of Bucharest;
Nicoleta
N
Dumitru
Cardiology Clinic, Monza Hospital;
Ana G
AG
Fruntelata
Prolife Medical Clinic, Bucharest, Romania.
Smarandita
S
Lacau
University of Medicine and Pharmacy, Carol Davila, Internal Medicine Clinic;
Daniela
D
Bartos