Apical aneurism and myocardial bridging in a patient with hypertrophic cardiomyopathy: Association or consequence of the myocardial bridging?

The identification of high-risk patients with hypertrophic cardiomyopathy (HC) for primaryprevention of sudden cardiac death (SCD) remains a challenging issue, since major riskfactors sometimes lack specificity. We report the case of a patient with HC and association ofapical aneurysm and myocardial bridging who had been initially not implanted because shehad only one major risk factor. She subsequently experienced a sustained ventricular tachycardiathat finally motivated the implantation. We conclude that it is never an easy decision toimplant a preventive implantable cardioverter-defibrillator (ICD). Nevertheless, additionalcriteria for a better selection of patients who would benefit from an ICD implant are certainlyuseful.