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  • Title: Mid-ventricular obstructive hypertrophic cardiomyopathy associated with an apical aneurysm: evaluation of possible causes of aneurysm formation.
    Author: Sato Y, Matsumoto N, Matsuo S, Yoda S, Tani S, Kasamaki Y, Takayama T, Kunimoto S, Saito S.
    Journal: Yonsei Med J; 2007 Oct 31; 48(5):879-82. PubMed ID: 17963350.
    Abstract:
    Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) is a rare type of cardiomyopathy, associated with apical aneurysm formation in some cases. We report a patient presenting with ventricular fibrillation, an ECG with an above normal ST segment, and elevated levels of cardiac enzymes but normal coronary arteries. Left ventriculography revealed a left ventricular obstruction without apical aneurysm. There was a significant pressure gradient between the apical and basal sites of the left ventricle. Cine magnetic resonance imaging (MRI), performed on the 10th hospital day, showed asymmetric septal hypertrophy, mid-ventricular obstruction, and an apical aneurysm with a thrombus. The first evaluation by contrast-enhanced imaging showed a subendocardial perfusion defect and delayed enhancement. It was speculated that the intraventricular pressure gradient, due to mid- ventricular obstruction, triggered myocardial infarction, which subsequently resulted in apical aneurysm formation.
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