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Case Reports
. 2014 Feb 28:2014:bcr2013202532.
doi: 10.1136/bcr-2013-202532.

Idiopathic left ventricular apical hypoplasia

Ali Raza  1 , Mohammad Waleed, Matthew Balerdi, Thanjavur Bragadeesh, Andrew L Clark
Affiliations
Case Reports

Idiopathic left ventricular apical hypoplasia

Ali Raza et al. BMJ Case Rep. .

Abstract

A 46-year-old man was found to have an abnormal ECG taken during a routine health and blood pressure check. His only symptom was non-specific central chest discomfort, unrelated to exertion. His ECG showed sinus rhythm, a normal axis and poor R wave progression across the chest leads and lateral T wave flattening. An echocardiogram showed a dilated left ventricle with a thin and hypokinetic septum bulging to the right. The apex was 'not well seen' but also appeared thin and hypokinetic. The right heart and valves were normal. The patient was further investigated for left ventricular hypoplasia.

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Figures

Figure 1
Figure 1
Presenting ECG at the rapid access chest pain clinic showing poor R wave progression and lateral T wave inversion.
Figure 2
Figure 2
T2-weighted, vertical long axis two-chamber frame of steady state free procession (SSFP). Note the spherical left ventricle (A), the apex replaced by fat (B; see also figure 3 image 2), and papillary muscle arising from the abnormal apex (C).
Figure 3
Figure 3
Image 1—T2-weighted, steady state free procession (SSFP), four-chamber image. Note the ‘wrap-around’ right ventricle (D) that occupies the space normally reserved for the left ventricular apex. Image 2—fat suppression sequence in the four-chamber view showing the left ventricular apex completely suppressed (E).
See this image and copyright information in PMC

References

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