Mid-ventricular obstructive hypertrophic cardiomyopathy associated with an apical aneurysm: evaluation of possible causes of aneurysm formation.

Abstract:

:Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) is a rare type of cardiomyopathy, associated with apical aneurysm formation in some cases. We report a patient presenting with ventricular fibrillation, an ECG with an above normal ST segment, and elevated levels of cardiac enzymes but normal coronary arteries. Left ventriculography revealed a left ventricular obstruction without apical aneurysm. There was a significant pressure gradient between the apical and basal sites of the left ventricle. Cine magnetic resonance imaging (MRI), performed on the 10th hospital day, showed asymmetric septal hypertrophy, mid-ventricular obstruction, and an apical aneurysm with a thrombus. The first evaluation by contrast-enhanced imaging showed a subendocardial perfusion defect and delayed enhancement. It was speculated that the intraventricular pressure gradient, due to mid- ventricular obstruction, triggered myocardial infarction, which subsequently resulted in apical aneurysm formation.

journal_name

Yonsei Med J

journal_title

Yonsei medical journal

authors

Sato Y,Matsumoto N,Matsuo S,Yoda S,Tani S,Kasamaki Y,Takayama T,Kunimoto S,Saito S

doi

10.3349/ymj.2007.48.5.879

subject

Has Abstract

pub_date

2007-10-31 00:00:00

pages

879-82

issue

5

eissn

0513-5796

issn

1976-2437

pii

200710879

journal_volume

48

pub_type

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