Apical hypertrophic cardiomyopathy

Patient

43-year-old man hospitalized for follow-up of palpitations;

Trace

Sinus rhythm; left ventricular hypertrophy with major increase in R wave voltages from V2 to V6; incomplete right bundle branch block pattern (QRS duration 118 ms); absence of q waves in left precordial leads; negative T waves in leads I, aVL, V1-V6; giant negative T waves (> 10 mm) in V2-V3; ultrasound and MRI revealed a characteristic pattern of apical hypertrophic cardiomyopathy;

Patient

34-year-old man with apical hypertrophic cardiomyopathy;

Trace

Sinus rhythm; left ventricular hypertrophy with major increase in R wave voltages in V4-V5 and S wave voltages in V1-V2 (highly positive Sokolow index); absence of q waves in left precordial leads and in leads I, aVL; giant negative T waves (> 10 mm) in V4-V5;

Patient

18-year-old brother seen in consultation to determine if he is also afflicted with heart disease;

Trace

Electrical pattern similar to that of his brother, very suggestive of apical hypertrophic cardiomyopathy (left ventricular hypertrophy, absence of septal waves, giant negative T waves);

Exergue

The presence on the electrocardiogram of signs of left ventricular hypertrophy and giant negative T waves with the disappearance of septal q waves should evoke the diagnosis of apical hypertrophic cardiomyopathy. Performing an MRI enables eliminating differential diagnoses.