Mid-Ventricular Obstructive Hypertrophic Cardiomyopathy Associated with an Apical Aneurysm: Evaluation of Possible Causes of Aneurysm Formation.
10.3349/ymj.2007.48.5.879
- Author:
Yuichi SATO
1
;
Naoya MATSUMOTO
;
Shinro MATSUO
;
Shunichi YODA
;
Shigemasa TANI
;
Yuji KASAMAKI
;
Tadateru TAKAYAMA
;
Satoshi KUNIMOTO
;
Satoshi SAITO
Author Information
1. Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan. yuichis@med.nihon-u.ac.jp
- Publication Type:Case Report
- Keywords:
Mid-ventricular obstructive hypertrophic cardiomyopathy;
magnetic resonance imaging
- MeSH:
Cardiomyopathy, Hypertrophic/complications/*diagnosis;
Coronary Angiography;
Echocardiography, Doppler;
Heart Aneurysm/*diagnosis/etiology;
Humans;
Hypertrophy, Left Ventricular/complications/*diagnosis;
Magnetic Resonance Imaging, Cine;
Male;
Middle Aged;
Myocardial Ischemia/complications/diagnosis
- From:Yonsei Medical Journal
2007;48(5):879-882
- CountryRepublic of Korea
- Language:English
-
Abstract:
Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) is a rare type of cardiomyopathy, associated with apical aneurysm formation in some cases. We report a patient presenting with ventricular fibrillation, an ECG with an above normal ST segment, and elevated levels of cardiac enzymes but normal coronary arteries. Left ventriculography revealed a left ventricular obstruction without apical aneurysm. There was a significant pressure gradient between the apical and basal sites of the left ventricle. Cine magnetic resonance imaging (MRI), performed on the 10th hospital day, showed asymmetric septal hypertrophy, mid-ventricular obstruction, and an apical aneurysm with a thrombus. The first evaluation by contrast-enhanced imaging showed a subendocardial perfusion defect and delayed enhancement. It was speculated that the intraventricular pressure gradient, due to mid- ventricular obstruction, triggered myocardial infarction, which subsequently resulted in apical aneurysm formation.
