The use of contrast echocardiographyin the diagnosis of apical hypertrophic cardiomyopathy.case report and literary reference

Authors: Golukhova E.Z.1, Mashina T.V.1, Mrikaev D.V.1, Ruzina E.V.1, Grigor'ev V.S. 1, Aleksandrova S.A.1, Serebrennikov I.I.2

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation;
2 Moscow Regional Ambulance Station, ulitsa Znamenskaya, 3, Krasnogorsk, Krasnogorsk district, Moscow region, 143405, Russian Federation

For correspondence:  Sign in or register.

Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2019-13-1-71-78

For citation: Golukhova E.Z., Mashina T.V., Mrikaev D.V., Ruzina E.V., Grigor’ev V.S., Aleksandrova S.A., Serebrennikov I.I. The use of contrast echocardiography in the diagnosis of apical hypertrophic cardiomyopathy. Case report and literary reference. Creative Cardiology. 2019; 13 (1): 71–8 (in Russ.). DOI: 10.24022/1997-3187-2019-13-1-71-78

Received / Accepted:  28.01.2019/03.02.2019

Keywords: hypertrophic cardiomyopathy takotsubo syndrome coronary heart disease contrast echocardiography magnetic resonance imaging

Download
Full text:  

 

Abstract

Hypertrophic cardiomyopathy is characterized by an increase of left ventricle (LV) myocardium thickness in the absence of volume and pressure overloads. Apical hypertrophy is a relatively rare form of hypertrophic cardiomyopathy. A 70-year-old patient suffered from exertional angina and dyspnea of moderate severity. An electrocardiogram revealed negative T in all chest leads. Echo revealed hypertrophy of the LV middle and basal segments. According to the results of coronary angiography, coronary arteries had no hemodynamically significant stenosis. Ventriculography revealed akinesis with signs of hypertrophy proximal to the apical region. Contrast echocardiography revealed a narrow isthmus at the distal third of the LV, leading to LV obstruction in the apical region. Marked myocardial concentric hypertrophy was noted below the narrowing. Based on the data of contrasting echocardiography, we made a diagnosis of apical hypertrophic cardiomyopathy. A rare form of hypertrophic cardiomyopathy – apical hypertrophic cardiomyopathy should be included in the differential diagnosis of patients with angina.

References

  1. Albanesi Filho F.M., Castier M.B., Lopes A.S., Ginefra P. Is the apical hypertrophic cardiomyopathy seen in one population in Rio de Janeiro city similar to that found in the East? Arq. Bras. Cardiol. 1997; 69: 117–23. DOI: 10.1590/S0066-782X1997000800007
  2. Sakamoto Т., Tei C., Murayama M. et al. Giant T-wave inversion as a manifestation of asymmetrical apical hypertrophy (AAH) of the left ventricle. Jap. Heart J. 1976; 17: 617–29. DOI: 10.1536/ihj.17.611
  3. Kitaoka H., Doi Y., Casey S.A., Hitomi N., Furuno T., Maron B.J. Comparison of prevalence of apical hypertrophic cardiomyopathy in Japan and the United States. Am. J. Cardiol. 2003; 92: 1183–6. DOI: 10.1016/j.amjcard.2003.07.027
  4. Amosova E.N. Cardiomyopathy. Kiev: Kniga plyus; 1999 (in Russ.)
  5. Eriksson M.J., Sonnenberg B., Woo A. et al. Longterm outcome in patients with apical hypertrophic cardiomyopathy. J. Am. Coll. Cardiol. 2002; 39: 638–45. DOI: 10.1016/S0735-1097(01)01778-8
  6. Ceyhan C., Tekten T., Onbasili O.A., Ercan E. Transient ischemic attack with apical hypertrophic cardiomyopathy. Jpn. Heart J. 2003; 44: 285–9. DOI: 10.1536/jhj.44.285
  7. Bockeria L.A. Hypertrophic obstructive cardiomyopathy. Russian Annals of Surgery. 2013; 5: 5–14 (in Russ.).
  8. Bockeria L.A., Alekhin M.N., Mashina T.V., Mrikaev D.V., Golukhova E.Z. Modern ultrasound technologies in cardiology and cardiac surgery. Moscow; 2018 (in Russ.).
  9. Ghadri J.-R., Wittstein I.Sh., Prasad A., Sharkey S., Dote K., Akashi Y.J. et al. International expert consensus document on takotsubo syndrome (part I): clinical characteristics, diagnostic criteria, and pathophysiology. Eur. Heart J. 2018; 39 (22): 2032–46. DOI: 10.1093/EURHEARTJ/EHY076

About Authors

  • Elena Z. Golukhova, Dr Med. Sc., Academician of Russian Academy of Sciences,
  • Head of Department, ORCID
  • Tat'yana V. Mashina, Cand. Med. Sc., Senior Researcher, ORCID
  • David V. Mrikaev, Cand. Med. Sc., Researcher, ORCID
  • Evgeniya V. Ruzina, Postgraduate, Cardiologist, ORCID
  • Viktor S. Grigor'ev, Endovascular Surgeon, ORCID
  • Svetlana A. Aleksandrova, Cand. Med. Sc., Senior Researcher, ORCID
  • Igor' I. Serebrennikov, Deputy Chief Physician

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery