The use of contrast echocardiography in the diagnosis of apical hypertrophic cardiomyopathy. case report and literary reference HTML

Authors: E.Z. Golukhova1, T.V. Mashina1, D.V. Mrikaev1, E.V. Ruzina1, V.S. Grigor'ev1, S.A. Aleksandrova1, I.I. Serebrennikov2

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

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Heading: Case reports

UDC: 616.127-007.61-073.43
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

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

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.

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About Authors

  • Elena Z. Golukhova, Dr Med. Sc., Academician of Russian Academy of Sciences,
  • Head of Department, orcid.org/0000-0002-6252-0322;
  • Tat'yana V. Mashina, Cand. Med. Sc., Senior Researcher, orcid.org/0000-0002-2020-5922;
  • David V. Mrikaev, Cand. Med. Sc., Researcher, orcid.org/0000-0003-4237-0758;
  • Evgeniya V. Ruzina, Postgraduate, Cardiologist, orcid.org/0000-0003-0887-7088;
  • Viktor S. Grigor'ev, Endovascular Surgeon, orcid.org/0000-0002-1456-4697;
  • Svetlana A. Aleksandrova, Cand. Med. Sc., Senior Researcher, orcid.org/0000-0002-7795-9709;
  • Igor' I. Serebrennikov, Deputy Chief Physician

Chief Editor

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