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A case report of apical aneurysms and myocardial perfusion deficit with myocardial necrosis due to hypertrophic cardiomyopathy.

Abstract Hypertrophic cardiomyopathy (HCM) is a disease that is characterized by inappropriate left ventricular and/or right ventricular hypertrophy and hypercontractility that is often asymmetrical and associated with microscopic evidence of myocardial fiber disarray. The aim of this study was to present a previously under-recognized subset of HCM patients with left ventricular (LV) apical aneurysms.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29794772
OWN - NLM
STAT- MEDLINE
DCOM- 20180604
LR  - 20180604
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 21
DP  - 2018 May
TI  - A case report of apical aneurysms and myocardial perfusion deficit with
      myocardial necrosis due to hypertrophic cardiomyopathy.
PG  - e10829
LID - 10.1097/MD.0000000000010829 [doi]
AB  - RATIONALE: Hypertrophic cardiomyopathy (HCM) is a disease that is characterized
      by inappropriate left ventricular and/or right ventricular hypertrophy and
      hypercontractility that is often asymmetrical and associated with microscopic
      evidence of myocardial fiber disarray. The aim of this study was to present a
      previously under-recognized subset of HCM patients with left ventricular (LV)
      apical aneurysms. PATIENTS CONCERNS: A 33-year-old man who presented with chest
      discomfort for 10 days. He had an emerging apical aneurysm in the LV without
      midventricular obstruction. He had been diagnosed with apical HCM via abnormal
      electrocardiograms (ECG) and single-photon emission computed tomography (SPECT)
      for 10 years. This time, a new significant change in ECG and SPECT was
      identified. Late gadolinium enhancement (LGE) was observed by cardiac magnetic
      resonance imaging (MRI), and SPECT showed myocardial fibrosis or necrosis
      involving the apical aneurysm and proximal portion of the heart, which was
      confirmed by left ventriculography. DIAGNOSES: We present a relatively rare case 
      of HCM patients with apical aneurysms, accompaning by myocardial necrosis markers
      increased due to ventricular muscle stress increases, rather than obstructive
      coronary artery disease. INTERVENTIONS: The patient was prescribed aspirin,
      metoprolol tartrate, perindopril, and atorvastatin and was strongly advised to
      quit cigarettes and reduce weight. OUTCOMES: Follow-up at half a year turned out 
      well. LESSONS: LGE with a notable progression by ECG and SPECT along with an
      increase in myocardial necrosis markers in HCM patients with apical aneurysms, as
      was noted in the present case, is a relatively rare occurrence. Our present case 
      may provide unique insights into the adverse remodelling process and the
      formation of apical aneurysms in HCM patients.
FAU - Gao, Xiangyu
AU  - Gao X
AD  - Department of Cardiology.
FAU - Yang, Jigang
AU  - Yang J
AD  - Department of Nuclear Medicine.
FAU - Zhang, Xiaojie
AU  - Zhang X
AD  - Department of Radiology, Beijing Friendship Hospital, Capital Medical University,
      Xicheng District.
FAU - Wang, Ping
AU  - Wang P
AD  - Department of Cardiology.
FAU - Li, Hongwei
AU  - Li H
AD  - Department of Cardiology.
AD  - Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease,
      Beijing, China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aftercare
MH  - Cardiomyopathy, Hypertrophic/*complications/diagnostic imaging/drug
      therapy/pathology
MH  - Electrocardiography
MH  - Fibrosis/pathology
MH  - Heart/physiopathology
MH  - Heart Aneurysm/*complications/diagnostic imaging/physiopathology
MH  - Heart Ventricles/diagnostic imaging/*pathology/physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Myocardial Infarction/complications/diagnostic imaging
MH  - Myocardial Perfusion Imaging/methods
MH  - Myocardium/*pathology
MH  - Necrosis/pathology
MH  - Tomography, Emission-Computed, Single-Photon
MH  - Treatment Outcome
EDAT- 2018/05/26 06:00
MHDA- 2018/06/05 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/06/05 06:00 [medline]
AID - 10.1097/MD.0000000000010829 [doi]
AID - 00005792-201805250-00048 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(21):e10829. doi: 10.1097/MD.0000000000010829.