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Case Reports
. 2024 Oct 19;10(20):e38919.
doi: 10.1016/j.heliyon.2024.e38919. eCollection 2024 Oct 30.

Lateral hypertrophic cardiomyopathy: A case report

Emanuela Belmonte  1 , Luca Arcari  1   2 , Giovanni Camastra  1 , Federica Ciolina  3 , Massimiliano Danti  3 , Stefano Sbarbati  3 , Salvatore Donato Musarò  1 , Luca Cacciotti  1
Affiliations
Case Reports

Lateral hypertrophic cardiomyopathy: A case report

Emanuela Belmonte et al. Heliyon. .

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disorder, more often presenting with asymmetrical septal hypertrophy. Here we report the case of a patient, affected by arterial hypertension, presenting to the emergency department with chest pain, electrocardiographic changes and troponin rise. Further diagnostic work-up ruled out ischemic heart disease and lead to the diagnosis of a rare HCM phenotype affecting the lateral wall of the left ventricle. Cardiac magnetic resonance imaging proved to be a reliable diagnostic test in this case thanks to its tissue characterization ability, allowing the identification of diffuse fibrosis through native T1 mapping, edema through T2 mapping and replacement fibrosis with late gadolinium enhancement, providing us with robust diagnostic and prognostic information. The association of arterial hypertension with atypical HCM forms emerged from multicentric studies, however, further research is needed to fully clarify the complex interactions between arterial hypertension and phenotypic expression of HCM.

Keywords: Cardiac magnetic resonance imaging; Case report; Echocardiography; Lateral hypertrophic cardiomyopathy; T1 mapping.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
12-leads ECG showing sign of left ventricular hypertrophy and repolarization abnormalities (deep T-wave inversion).
Fig. 2
Fig. 2
images from echocardiography, 4-chamber (panel A) and cardiac magnetic resonance cine imaging, 4-chamber (panel B) both taken in tele-diastole, showing hypertrophy of the lateral left ventricular wall. Presence of apically displaced papillary muscle (asterisk in panel B).
Fig. 3
Fig. 3
cardiac magnetic resonance imaging at mid-short-axis level of the left ventricle (LV), showing increased native T1 of the lateral wall (panel A) as well as increased T2 in the same location (panel B) associated with increased signal intensity n T2-STIR imaging (arrows in panel C) and slight hyperintensity in the post contrast late gadolinium enhancement sequence (arrows in panel D); these findings are consistent with mild edema and non-ischemic fibrosis of the most hypertrophied LV areas.
See this image and copyright information in PMC

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