Hypertrophic cardiomyopathy - apical pattern with midventricular obstruction
Mild dyspnea upon exertion and mild chest pain.
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apical hypertrophic cardiomyopathy with midventricular obstruction.
LGE and PSIR gado both show patchy midwall fibrosis with subendocardial involvement in the apex. Apical subendocardial necrosis may have been involved in chest pain.
This pattern of sarcomeric hypertrophic cardiomyopathy is less common than the anteroseptoapical asymmetrical classical one and less common than the inferoseptal pattern one.
Prognosis with this apical pattern is probably worsened due to increased incidence of adverse cardiac events.