APICAL HYPERTROPHIC CARDIOMYOPATHY

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: Apical hypertrophic cardiomyopathy (AHCM) is an uncommon variant of (HCM). Significantly, sudden cardiac death less likely to occur in patients with isolated AHCM, and overall cardiovascular morbidity may be common than other HCM phenotypes. Available outcome studies are insufficiently powered for robust conclusions, individual AHCM at high risk morbidity. We describe a case patient presenting symptoms similar acute coronary syndrome she was incidentally found have apical cardiomyopathy. CASE PRESENTATION: 49 year old woman presented the emergency department palpitations squeezing 8/10 chest pain. Blood pressure 185/102 mmHg, heart rate 80 bpm. High sensitivity troponins were seven ng/L (ref range 0-11 ng/L). Initial electrocardiogram showed ST depressions V3 through V6 diffuse T wave inversions. The continued pain, so left catheterization performed, which did not show any obstructive artery disease. subsequently underwent transthoracic echocardiogram wall motion or valvular abnormality. It note that segment ventricle appeared hypertrophic. She discharged plans outpatient MRI. evaluated implantation cardioverter-defibrillator. DISCUSSION: (ApHCM) falls under umbrella (HCM) autosomal dominant mutations.(1) Specific diagnostic criteria diagnose ApHCM still well established. In study conducted by Klarish et al, increased mortality reported women possibly associated development atrial fibrillation higher baseline age.(2) Our emphasizes need clinicians mindful etiologies pain some cases, can missed echocardiography. CONCLUSIONS: mechanisms actin essential myosin light chain mutations produce unknown. Further elucidation relationship between changes contractile function produced specific mutation help explain diversity morphologies HCM.(3) REFERENCE #1: Hughes RK, Knott KD, Malcolmson J, Augusto JB, Mohiddin SA, Kellman P, Moon JC, Captur G. Hypertrophic Cardiomyopathy: Variant Less Known. J Am Heart Assoc. 2020 Mar 3;9(5):e015294 #2: Klarich KW, Jost CHA, Binder Connolly HM, Scott CG, Freeman WK, Ackerman MJ, Nishimura RA, Tajik AJ, Ommen SR. Risk long-term follow-up Cardiol. 2013;111:1784–1791 #3: Arad M, Penas-Lado Monserrat L, al. Gene Circulation 2005;112:2805-2811 DISCLOSURES: No relevant relationships Nishad Barve, source=Web Response HANAD BASHIR, david cutler, NICOLE LAO,