Ace-of-spades sign refers to the pathognomonic configuration of the left ventricle as seen in apical hypertrophy 1-3.
It consists of marked ventricular wall thickening at the apex resulting in cavity narrowing at the apex with a relatively normal appearance of the mid-ventricular to basal wall and cavity. On a longitudinal view of the left ventricle, this results in an appearance resembling a playing card spade. It can be demonstrated on echocardiography, ventriculography and cardiac MRI.
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- 2. Siewe D, Nichols KB, Furney SL et-al. King of hearts for ace of spades: apical hypertrophic cardiomyopathy. Am. J. Med. 2014;127 (1): 31-3. doi:10.1016/j.amjmed.2013.10.001 - Pubmed citation