Diagnostics of rare forms of asymmetrical hypertrophic cardiomyopathy

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The article presents a clinical example of an asymptomatic obstructive form of hypertrophic cardiomyopathy (HCM) with obstruction locus localized in the middle part of the left ventricular (LV) cavity. In case of apical asymmetric form of HCM (in our variant, with involvement of the mid-LV segments), there is no connection between the obstruction and anterior systolic movement of anterior mitral valve leaflet, so it could be missed during an echocardiographic (EchoCG) examination. The suspicion of the presence of HCM in asymptomatic patients is formed during the analysis of resting electrocardiography (ECG), and the methods for this diagnosis confirmation are ECG and magnetic resonance imaging. The purpose of the publication is to increase doctors’ awareness in recognizing ECG signs of HCM in patients, which can allow to make a targeted examination of the ventricular cavity for HCM echocardiographic signs detection.

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作者简介

Alla Golosova

Russian University of Medicine of the Ministry of Healthcare of Russia

编辑信件的主要联系方式.
Email: golosovaalla@mail.ru
ORCID iD: 0000-0002-2562-9839

MD, PhD (Medicine), associate professor of the Department of hospital therapy No. 1 of the Faculty of general medicine

俄罗斯联邦, 127006, Moscow, 4 Dolgorukovskaya St.

Sergey Gatsura

Russian University of Medicine of the Ministry of Healthcare of Russia

Email: svgats@mail.ru
ORCID iD: 0000-0002-1513-5149

MD, Dr. Sci. (Medicine), professor of the Department of hospital therapy No. 1 of the Faculty of general medicine

俄罗斯联邦, 127006, Moscow, 4 Dolgorukovskaya St.

Natalya Finashova

V.P. Demikhov City Clinical Hospital the of Department of Healthcare of Moscow

Email: fin-nata1@yandex.ru

MD, cardiologist at the Outpatient and Polyclinic Center

俄罗斯联邦, 109263, Moscow, 4 Shkuleva St.

参考

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2. Fig. 1. Resting electrocardiogram of the observed patient dated 02/27/2024

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3. Fig. 2. Hypertrophy of the apical lateral and partially middle anterolateral segments of the left ventricle (white arrows) in the observed patient with a maximum of up to 16 mm (recorded as measurement 1)

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4. Fig. 3. Echocardiography of the observed patient: closure of the walls of the left ventricle in the area of the median segments into the systole in the presence of a hypokinetic apical septal segment of the left ventricle. Left ventricle on the left

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5. Fig. 4. Echocardiography of the observed patient: the blood flow velocity at the junction of the walls of the left ventricle is 4.3 m/s and the maximum systolic gradient is up to 73 mmHg.

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6. Fig. 5. Magnetic resonance imaging of the heart of the observed patient with contrast

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7. Fig. 6. Magnetic resonance imaging of the heart of the observed patient

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8. Fig. 7. Magnetic resonance imaging of the heart of the observed patient with contrast

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