Continuous apex to left ventricle blood flow pattern in hypertrophic cardiomyopathy with apical aneurysm and midventricular obstruction

Echocardiography
Bill P C HsiehCynthia Taub

Abstract

A 42-year-old female presented with chest pain, noted to have systolic and diastolic murmurs on physical examination and left ventricular hypertrophy on the electrocardiogram. Echocardiography with contrast enhancement revealed hypertrophic cardiomyopathy (HCM) with apical aneurysm and mid left ventricular cavity obstruction. Doppler interrogation showed continuous systolic and diastolic flow from the apex to left ventricle (LV) with a transient deceleration giving rise to a notched pattern. Myocardial ischemia of the apex was demonstrated on adenosine nuclear scintigraphy without epicardial coronary obstruction on angiography. This case demonstrates a novel Doppler pattern with continuous apex to LV flow in HCM in the setting of apical ischemia that may account for the formation of the aneurysm.

Citations

Jan 24, 2016·The American Journal of the Medical Sciences·Yan XiaoJian-Jun Li
Jul 16, 2015·Echocardiography·Vito Maurizio ParatoNatesa G Pandian
May 23, 2018·Pacing and Clinical Electrophysiology : PACE·Moustafa O ElsheshtawyJacob Shani
Jun 20, 2015·World Journal of Clinical Cases·Marie-France PoulinChristopher Madias

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