Apical Hypertrophic Cardiomyopathy: Clinical, Electrocardiographic, Scintigraphic, Echocardiographic, and Magnetic Resonance Imaging Findings of a Case

The apical variant of nonobstructive hypertrophic cardiomyopathy (HCM) constitutes a minority of all cases of HCM and generally carries a favorable clinical outcome. We describe a 68 year-old Caucasian woman who presented with exertional dyspnea. The patient underwent stress testing with electrocardiogram-gated single-photon emission computed tomography imaging and resting transthoracic echocardiography. The patient also underwent cardiac magnetic resonance imaging at rest, including conventional structural and functional imaging and cine complementary spatial modulation of magnetization-tagged imaging (CSPAMM). The noninvasive evaluation of the heart demonstrated apical hypertrophy with regional systolic dysfunction, establishing the diagnosis of apical HCM. This case suggests a potential value of CSPAMM in characterizing apical HCM.