Apical hypertrophic cardiomyopathy
Presentation
Abnormal CT chest and hence MRI of heart ordered for evaluating cardiac apex.
Patient Data
Chest
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Fat density seen at apex of the heart.
Apex is thick, easier to appreciate in retrospect.
Cardiac
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Left ventricular function: Hyperdynamic left ventricular systolic function.
Valvular function: There is no systolic anterior motion of the mitral valve.
Delayed enhancement: Tiny focus of delayed myocardial enhancement at the distal apex of the septum towards the left ventricle.
Case Discussion
Findings are suggestive of apical hypertrophic cardiomyopathy. There is no apical aneurysm.
Recommend 12-lead electrocardiogram to evaluate for T-wave inversion. Look at apex on 3 chamber in diastole, not thinned out as usual. Spade like appearance.