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      Apical Hypertrophic Cardiomyopathy: A Case Report

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          Abstract

          Apical hypertrophic cardiomyopathy (ApHCM) is a rare variant of hypertrophic cardiomyopathy, characterized by a spade-like left ventricular cavity. A 58-year-old African-American female with past medical history of hypertension presented for evaluation of recurrent exertional chest tightness, palpitations and headache. Prior workup including multiple stress tests and angiogram was non-conclusive. Electrocardiogram (EKG) showed characteristic marked T-waves inversions in inferior leads and left ventriculography revealed left ventricle apical hypertrophy with spade like left ventricular cavity that was typical of Yamaguchi syndrome. This case highlights the rare incidence of the disease among African American as well as the challenging diagnostic and presentation features of the disease.

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          Most cited references28

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          Long-term outcome in patients with apical hypertrophic cardiomyopathy.

          The aim of this study was to describe long-term outcome in patients with apical hypertrophic cardiomyopathy (ApHCM) followed in a tertiary referral center. Apical hypertrophic cardiomyopathy is a relatively rare form of hypertrophic cardiomyopathy (HCM), first described in Japan. Initial reports, based on a limited number of patients, emphasized the benign nature of this condition. A retrospective study of 105 patients with ApHCM diagnosed at the Toronto General Hospital from 1975 to 2000 was performed. Symptoms, clinical findings, mortality and cardiovascular morbidity were analyzed. The mean age at presentation was 41.4 +/- 14.5 years. During a mean follow-up of 13.6 +/- 8.3 years from presentation, cardiovascular mortality was 1.9% (2/105) and annual cardiovascular mortality was 0.1%. Overall survival was 95% at 15 years. Thirty-two patients (30%) had one or more major morbid events, the most frequent being atrial fibrillation (12%) and myocardial infarction (10%). Probability of survival without morbid events was 74% at 15 years. Three predictors of cardiovascular morbidity were identified: age at presentation or = II at baseline. Forty-four percent of the patients were asymptomatic at the time of last follow-up. Apical hypertrophic cardiomyopathy in North American patients is not associated with sudden cardiac death and has a benign prognosis in terms of cardiovascular mortality. Nevertheless, one third of these patients experience serious cardiovascular complications, such as myocardial infarction and arrhythmias. These data are likely to influence the counseling and management of patients with ApHCM.
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            2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

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              Hypertrophic nonobstructive cardiomyopathy with giant negative T waves (apical hypertrophy): ventriculographic and echocardiographic features in 30 patients.

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                Author and article information

                Journal
                Cardiol Res
                Cardiol Res
                Elmer Press
                Cardiology Research
                Elmer Press
                1923-2829
                1923-2837
                October 2017
                27 October 2017
                : 8
                : 5
                : 265-268
                Affiliations
                [a ]Advocate Illinois Masonic Medical Center, Chicago, IL, USA
                Author notes
                [b ]Corresponding Author: Ashraf Abugroun, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave., Chicago, IL 60657, USA. Email: ashraf.abugroun@ 123456advocatehealth.com
                Article
                10.14740/cr619w
                5667717
                29118892
                51dc66ed-346b-4fd8-a032-fbef3061b650
                Copyright 2017, Abugroun et al.

                This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 October 2017
                : 18 October 2017
                Categories
                Case Report

                apical hypertrophic cardiomyopathy,yamaguchi syndrome,african american,coronary angiography,ventriculography

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