ArticleJACC. Case reports2025
Diagnostic Ambiguity in Apical Hypertrophic Cardiomyopathy: Case-Based Insights and Review of Evolving Criteria.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundApical hypertrophic cardiomyopathy (HCM) is a unique subtype of HCM characterized by predominant hypertrophy of the left ventricular apex. Due to its unique morphology, apical HCM often manifests with nonspecific symptoms, leading to a challenging diagnosis. Apical measurements on transthoracic echocardiography may be altered depending on the quality and technique with which the images were obtained; thus advanced imaging, such as cardiac magnetic resonance (CMR), may be needed to establish the diagnosis. CASE SUMMARY: We present 2 cases in which patients presented with nonspecific symptoms and initial transthoracic echocardiography was inconclusive for apical HCM, requiring CMR to better visualize structural changes and establish the diagnosis. DISCUSSION: Apical HCM remains an elusive subtype of HCM given its variable presentation and subtle structural changes. Our cases highlight the significant advantage of CMR to better characterize structural changes that may be overlooked on standard echocardiography to help diagnose apical HCM.
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