J Cardiovasc Ultrasound.  2016 Sep;24(3):239-242. 10.4250/jcu.2016.24.3.239.

Findings of Cardiac Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy after 16 Years

• Kim GH
• Kim CM
• Jang BH
• Lee HH
• Hong S
• Eum SH
• Jeon H
• Moon D

• KMID: 2353102
• DOI: http://doi.org/10.4250/jcu.2016.24.3.239

Abstract

A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years.

Keyword

Hypertrophic cardiomyopathy; Microvascular dysfunction; Cardiac magnetic resonance imaging

MeSH Terms

Cardiomyopathies
Cardiomyopathy, Hypertrophic*
Coronary Angiography
Coronary Vessels
Death, Sudden
Diagnosis
Echocardiography
Follow-Up Studies
Humans
Magnetic Resonance Imaging*
Middle Aged

Figure

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  Fig. 1 After 7 years, transthoracic echocardiography M-mode image (A), four chamber view (C), after 16 years, M-mode image (B), and four chamber view (D).

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  Fig. 2 Delayed enhancement images demonstrating hyperenhancement (arrows) involving the myocardium and epicardium irrespectively territory of coronary artery.

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