Heart Care Info - Heart Disease Prevention & Treatment

Multimodality Imaging of Left Ventricular Apical Pouch With Midventricular Cavity Obliteration: Rare Variant of Hypertrophic Cardiomyopathy

MF Jan, TE Paterick, KA Ammar... - Journal of the ..., 2012 - Am Coll Cardio Found Transthoracic echocardiography (TTE) performed on a 52-year-old man for an abnormal electrocardiogram (A) demonstrated severe midventricular hypertrophy (30 mm)(Online Videos 1 and 2), a left ventricular apical pouch (B, pink arrow, Online Videos 3 and 4), and ...

Transthoracic echocardiography (TTE) performed on a 52-year-old man for an abnormal electrocardiogram (A) demonstrated severe midventricular hypertrophy (30 mm) (Online Videos 1 and 2), a left ventricular apical pouch (B, pink arrow, Online Videos 3 and 4), and a midventricular systolic gradient of 40 mm Hg (C, white arrows). Characteristic diastolic velocity profile of the pouch was noted (C, white arrowheads), with mitral inflow and apical pouch flow colliding "head-on" in the midventricle, producing a vivid color display (D and inset, white arrows, Online Video 5). Strain analysis revealed decreased peak systolic strain limited to the apicolateral wall (E). Cardiac magnetic resonance imaging confirmed TTE findings (F, pink arrow) but did not reveal delayed hyperenhancement (Online Video 6). A previously performed left ventriculogram also demonstrated the apical pouch (G, white arrow).