Hypertrophic cardiomyopathy with a large apical ventricular aneurysm and mural thrombus

Authors

  • Munis Raza Grand Rapids Medical Education Partners/Michigan State University Internal Medicine Residency, Grand Rapids, Michigan
  • Nagib Chalfoun Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
  • Abdallah Wissam Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
  • Hamza Hashmi Grand Rapids Medical Education Partners/Michigan State University Internal Medicine Residency, Grand Rapids, Michigan
  • Richard McNamara Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan

DOI:

https://doi.org/10.21542/gcsp.2018.9

Abstract

Hypertrophic cardiomyopathy (HCM) is characterized by increased left ventricular wall thickness in the absence of any other identifiable cause of thickness. It predisposes the patient to increased risk of sudden cardiac death (SCD) due to fatal arrhythmias. Approximately 2% of the HCM patients have left ventricular apical aneurysm. CMR imaging is better in identifying this apical aneurysm as compared to echocardiogram. This apical aneurysm, which can be akinetic or dyskinetic, increases the risk of disease-related adverse events as compared to general HCM. These adverse disease-related events include SCD, thromboembolism, and symptoms of heart failure. We report a rare case of hypertrophic cardiomyopathy in association with Williams- Beuren Syndrome. On CMR imaging, patient was found to have a large apical aneurysm and mid- ventricular obstruction with underlying thrombus. He was started on oral anticoagulation, and ICD was recommended. 

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Published

2018-03-17

Issue

Section

Images in cardiology