Lateral hypertrophic cardiomyopathy: A case report

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

• Lateral hypertrophic cardiomyopathy
• Echocardiography
• Cardiac magnetic resonance imaging
• T1 mapping
• Case report