Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Sep 7;10(9):e3267.
doi: 10.7759/cureus.3267.

Ventricular Fibrillation Cardiac Arrest in African American Male with Apical Hypertrophic Cardiomyopathy

Giselle Volney  1 , Habiba Wada  2 , Michael Tatusov  3
Affiliations
Case Reports

Ventricular Fibrillation Cardiac Arrest in African American Male with Apical Hypertrophic Cardiomyopathy

Giselle Volney et al. Cureus. .

Abstract

Apical hypertrophic cardiomyopathy (AHCM) is a rare form of non-obstructive hypertrophic cardiomyopathy. It is rarely reported in African American patients, and more commonly reported in Japanese patients. AHCM involves hypertrophy of the apex of the left ventricle. It is considered to have a benign prognosis in terms of cardiovascular mortality, however arrhythmias and sudden cardiac death have been reported. We report a case of a 49-year-old African American male with a history of hypertension, who presented to the emergency department after in field defibrillation for ventricular fibrillation cardiac arrest with return of spontaneous circulation after 10 minutes of cardiopulmonary resuscitation. Features of left ventricular hypertrophy and deep T-wave inversions in V3-V6 were noted on a 12-lead electrocardiogram which were suggestive of AHCM. Left heart catheterization with left ventriculography and coronary angiography confirmed the diagnosis of AHCM with the classic "ace of spades" sign. This case highlights the rare occurrence of AHCM with ventricular fibrillation cardiac arrest in an African American male, treated with hypertension management, aspirin, atorvastatin and automated implantable cardioverter-defibrillator placement.

Keywords: ace of spades; apical hypertrophic cardiomyopathy; ventricular fibrillation.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Deep T wave inversions in V3-V6 in a patient with apical hypertrophic cardiomyopathy (AHCM).
Figure 2
Figure 2. Persistence of deep T wave inversions in V3 to V6 of a patient with AHCM.
AHCM: Apical hypertrophic cardiomyopathy
Figure 3
Figure 3. Classic “Ace of Spades” sign on ventriculogram of a patient with AHCM.
AHCM: Apical hypertrophic cardiomyopathy
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. A rare case of apical hypertrophic cardiomyopathy (AHCM) [Jun;2018 ];Mirabbasi SA, Khalighi K, Mukkamala S, Kodali A. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473187/ J Community Hosp Intern Med Perspect. 2017 7:122–125. - PMC - PubMed
    1. Sustained ventricular tachycardia in apical hypertrophic cardiomyopathy, midcavitary obstruction, and apical aneurysm. Sanghvi NK, Tracy CM. Pacing Clin Electrophysiol. 2007;30:799–803. - PubMed
    1. Electrocardiogram in apical hypertrophic cardiomyopathy with a speculation as to the mechanism of its features. [Jun;2018 ];Madias JE. Neth Heart J. 2013 21:268–271. - PMC - PubMed
    1. Apical hypertrophic cardiomyopathy. [Jun;2018 ];Stainback RF. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461654/ Tex Heart Inst J. 2012 39:747–749. - PMC - PubMed
    1. Gene mutations in apical hypertrophic cardiomyopathy. [Jun;2018 ];Arad M, Penas-Lado M, Monserrat L, et al. Circulation. 2005 112:2805–2811. - PubMed

Publication types

LinkOut - more resources