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. 2017 May 29:11:1179546817710934.
doi: 10.1177/1179546817710934. eCollection 2017.

Histologic Sequelae of Apical Hypertrophic Cardiomyopathy: Dystrophic Calcification

Shahryar G Saba  1   2 , John N Makaryus  1 , Navid Rahmani  2 , Ram Jadonath  1
Affiliations

Histologic Sequelae of Apical Hypertrophic Cardiomyopathy: Dystrophic Calcification

Shahryar G Saba et al. Clin Med Insights Cardiol. .

Abstract

We present cardiac computed tomography (CT) findings demonstrating apical hypertrophic cardiomyopathy with dystrophic calcification of the left ventricular apex. The absence of significant epicardial coronary artery disease demonstrated by coronary CT angiography suggests that increased wall tension and decreased microvascular perfusion over time account for the dyskinetic apical myocardium, rather than myocardial infarction secondary to atherosclerotic plaque rupture. These observations support CT as the imaging modality of choice to visualize the deposition of calcium in injured myocardial tissue, a recognized occurrence in chronically infarcted myocardium.

Keywords: Hypertrophic cardiomyopathy; multidetector cardiac CT; myocardial calcification.

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Conflict of interest statement

DECLARATION OF CONFLICTING INTERESTS: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Noncontrast cardiac computed tomography. (A) The 4-chamber view shows calcification of the apical left ventricular myocardium. (B) The short-axis view of the left ventricular apex shows circumferential calcification of the apical myocardium.
Figure 2
Figure 2
Contrast-enhanced gated cardiac computed tomography. (A) The 2-chamber view at (A1) end-diastole and (A2) end-systole shows a spade-shaped left ventricular cavity with mild apical hypertrophy and partial systolic cavity obliteration. (B) The 4-chamber view at (B1) end-diastole and (B2) end-systole demonstrates apically displaced and hypertrophied papillary muscles. (C) Contrast-enhanced short-axis views at (C1) end-diastole and (C2) end-systole show a slightly larger apical cavity at end-systole, consistent with dyskinetic myocardium.
Figure 3
Figure 3
Echocardiography. (A) Transesophageal and (B) transthoracic echocardiography demonstrate increased echogenicity at the left ventricular apex, however, less conspicuous compared with the calcification noted on noncontrast cardiac computed tomography.
See this image and copyright information in PMC

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