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KMID : 0311120070480050879
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Yonsei Medical Journal
2007 Volume.48 No. 5 p.879 ~ p.882
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Mid-Ventricular Obstructive Hypertrophic Cardiomyopathy Associated with an Apical Aneurysm: Evaluation of Possible Causes of Aneurysm Formation
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Sato Yuichi
Matsumoto Naoya
Matsuo Shinro
Tani Shigemasa
Kasamaki Yuji
Takayama Tadateru
Kunimoto Satoshi
Saito Satoshi
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Abstract
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Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) is a rare type of cardiomyopathy, associated with apical aneurysm formation in some cases. We report a patient presenting with ventricular fibrillation, an ECG with an above normal ST segment, and elevated levels of cardiac enzymes but normal coronary arteries. Left ventriculography revealed a left ventricular obstruction without apical aneurysm. There was a significant pressure gradient between the apical and basal sites of the left ventricle. Cine magnetic resonance imaging (MRI), performed on the 10th hospital day, showed asymmetric septal hypertrophy, mid-ventricular obstruction, and an apical aneurysm with a thrombus. The first evaluation by contrast-enhanced imaging showed a subendocardial perfusion defect and delayed enhancement. It was speculated that the intraventricular pressure gradient, due to mid- ventricular obstruction, triggered myocardial infarction, which subsequently resulted in apical aneurysm formation
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KEYWORD
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Mid-ventricular obstructive hypertrophic cardiomyopathy, magnetic resonance imaging
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