PDF(Pubmed)
Abstract：
UNASSIGNED: Apical hypertrophic cardiomyopathy (ApHCM) is a rare form of hypertrophic cardiomyopathy which predominantly affects the apex of the left ventricle. The diagnosis can be challenging due to several factors, ranging from no typical clinical and electrocardiogram (EKG) findings to potential difficulties in executing and interpreting the echocardiographic examination.
UNASSIGNED: We report the case of an 84-year-old woman who came to our echo-lab to undergo a routine echocardiogram. She had a history of permanent atrial fibrillation, paced rhythm and previous episodes of heart failure (HF), allegedly explained by a diagnosis of hypertensive heart disease that had been confirmed many times over the previous 20 years. The clinical examination and the EKG were unremarkable. The echocardiographic images were poor quality. But a senior cardiologist, expert in imaging and echocardiography, noted the lack of delineation of the endocardial border of the left ventricular (LV) apex region. Contrast echocardiography was performed and severe apical hypertrophy discovered.
UNASSIGNED: ApHCM can be a challenging diagnosis. Contrast echocardiography must always be applied in cases of poor delineation of the LV apical endocardial border at baseline echocardiography. Timely detection and appropriate lifestyle intervention might slow the development of LV hypertrophy, and possibly minimize and delay heart failure (HF) related symptoms and arrhythmias. The prognosis remains relatively benign during long term follow-up.
UNASSIGNED: We report the case of an 84-year-old woman who came to our echo-lab to undergo a routine echocardiogram. She had a history of permanent atrial fibrillation, paced rhythm and previous episodes of heart failure (HF), allegedly explained by a diagnosis of hypertensive heart disease that had been confirmed many times over the previous 20 years. The clinical examination and the EKG were unremarkable. The echocardiographic images were poor quality. But a senior cardiologist, expert in imaging and echocardiography, noted the lack of delineation of the endocardial border of the left ventricular (LV) apex region. Contrast echocardiography was performed and severe apical hypertrophy discovered.
UNASSIGNED: ApHCM can be a challenging diagnosis. Contrast echocardiography must always be applied in cases of poor delineation of the LV apical endocardial border at baseline echocardiography. Timely detection and appropriate lifestyle intervention might slow the development of LV hypertrophy, and possibly minimize and delay heart failure (HF) related symptoms and arrhythmias. The prognosis remains relatively benign during long term follow-up.
摘要：
■心尖肥厚型心肌病（ApHCM）是一种罕见的肥厚型心肌病，主要影响左心室的心尖。由于几个因素，诊断可能具有挑战性，从没有典型的临床和心电图（EKG）发现到执行和解释超声心动图检查的潜在困难。
■我们报告了一个84岁的女性，她来到我们的回声实验室接受常规超声心动图检查。她有永久性心房颤动病史,节奏节奏和以前的心力衰竭（HF）发作，据称解释为高血压性心脏病的诊断，该诊断在过去20年中被多次证实。临床检查和心电图无明显变化。超声心动图图像质量较差。但是一位资深心脏病专家，成像和超声心动图专家，注意到缺乏对左心室（LV）心尖区的心内膜边界的描绘。进行了超声造影检查，发现了严重的心尖肥大。
■ApHCM可能是一个具有挑战性的诊断。在基线超声心动图中，如果LV心尖内膜边界轮廓较差，则必须始终应用超声心动图。及时发现和适当的生活方式干预可能会减缓左心室肥大的发展，并可能减少和延迟心力衰竭（HF）相关症状和心律失常。在长期随访期间预后仍然相对良性。
■我们报告了一个84岁的女性，她来到我们的回声实验室接受常规超声心动图检查。她有永久性心房颤动病史,节奏节奏和以前的心力衰竭（HF）发作，据称解释为高血压性心脏病的诊断，该诊断在过去20年中被多次证实。临床检查和心电图无明显变化。超声心动图图像质量较差。但是一位资深心脏病专家，成像和超声心动图专家，注意到缺乏对左心室（LV）心尖区的心内膜边界的描绘。进行了超声造影检查，发现了严重的心尖肥大。
■ApHCM可能是一个具有挑战性的诊断。在基线超声心动图中，如果LV心尖内膜边界轮廓较差，则必须始终应用超声心动图。及时发现和适当的生活方式干预可能会减缓左心室肥大的发展，并可能减少和延迟心力衰竭（HF）相关症状和心律失常。在长期随访期间预后仍然相对良性。
