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Patient
Young man 18 years of age whose father and brother have hypertrophic cardiomyopathy without evidence of an associated mutation;
Trace
The electrocardiogram shows a sinus rhythm with no clear abnormalities; prominent amplitude of the S wave in V2 but no obvious signs of hypertrophy; cardiac ultrasound revealed no evidence of hypertrophy (septum 10 mm);
Trace
Electrocardiogram performed in this same patient 3 years later (at the age of 21 years); increase in R wave voltage in V4, V5, V6; ultrasound revealed a septal thickness at the upper limit of 11 mm;
Trace
Electrocardiogram performed in the same patient 3 years later (at the age of 24); very marked increase in R wave voltage in V4, V5, V6; the Sokolow index is very clearly positive; ultrasound revealed a septal thickness at the upper limit of 14 mm confirming the fact that this patient, like his brother and his father, does indeed have hypertrophic cardiomyopathy;
Exergue
In some patients, the onset of electrical signs suggestive of hypertrophic cardiomyopathy may be delayed, justifying repeating the recordings over time.
These tracings show the progression over time of the electrical signs in a patient with hypertrophic cardiomyopathy. The penetrance is variable, which explains why for a same family both clinical and ultrasound forms may be variable.