PDF(Pubmed)
Abstract：
Apical hypertrophic cardiomyopathy is a rare variant of hypertrophic cardiomyopathy characterized by abnormal heart muscle thickening, specifically affecting the left ventricle\'s apex. Classically revealing both giant T-wave inversions in the precordial leads of an electrocardiogram and a spade-like configuration of the left ventricular cavity on ventriculograms, the diagnosis of the apical variant has evolved with cardiac magnetic resonance imaging. Despite being well known among East Asian populations, the diagnosis of apical hypertrophic cardiomyopathy is often underestimated and overlooked among American patients due to the non-specific nature of echocardiography. In this case report, we present the diagnosis of apical hypertrophic cardiomyopathy in a middle-aged African American male with chronic palpitations. The diagnosis was confirmed using cardiac magnetic resonance imaging, which revealed extensive myocardial fibrosis. Ultimately, the patient was treated with an implantable cardioverter-defibrillator. Our case aims to enhance the understanding and facilitate the recognition and management of apical hypertrophic cardiomyopathy, particularly among non-Asian individuals. Current challenges revolve around robust risk stratification strategies for patients at high risk for sudden cardiac death that require device therapy.
摘要：
心尖肥厚型心肌病是肥厚型心肌病的一种罕见变种，其特征是心肌异常增厚，特别影响左心室的心尖。经典地揭示了心电图心前导联中巨大的T波倒置和心室图中左心室腔的铲状构型，心尖变异的诊断随着心脏磁共振成像的发展而发展。尽管在东亚人群中广为人知，由于超声心动图的非特异性,美国患者心尖肥厚型心肌病的诊断常被低估和忽视.在这个案例报告中,我们介绍了一名患有慢性心悸的中年非裔美国男性的心尖肥厚型心肌病的诊断。使用心脏磁共振成像证实了诊断，揭示了广泛的心肌纤维化。最终,患者接受了植入式心脏复律除颤器治疗.我们的案例旨在提高对心尖肥厚型心肌病的认识和治疗，特别是在非亚裔人群中。当前的挑战围绕着针对需要设备治疗的心源性猝死高风险患者的稳健风险分层策略。
