-
Views
-
Cite
Cite
Yukun Cao, Xiaowei Li, Jie Zhao, Heshui Shi, Cardiac magnetic resonance imaging of hypertrophic cardiomyopathy with left ventricular apical septal diverticulum, European Heart Journal - Cardiovascular Imaging, Volume 25, Issue 11, November 2024, Page e268, https://doi.org/10.1093/ehjci/jeae191
- Share Icon Share
Extract
A 48-year-old male was admitted due to intermittent chest tightness. He was found to have normal coronary arteries but a left ventricular (LV) myocardial thickening at a local hospital. His blood pressure and myocardial enzyme were within normal range. Cine magnetic resonance imaging (MRI) demonstrated moderate hypertrophy of the LV septum (mid-septum, 16 mm) with a normal LV ejection fraction (Panels A–C; Supplementary data online, Movies S1 and S2). Additionally, cine MRI revealed a 7 × 10 mm invagination in the LV apical septum that protruded into the right ventricle but exhibited synchronous contractility with the LV. First-pass perfusion showed the LV apical invagination and no significant perfusion defect in the LV myocardium (Panels D–F; Supplementary data online, Movie S3). Mapping sequences indicated elevated native T1 values (Panel G; mid-septum, 1315 ms; reference value 1105–1280 ms) and extracellular volume (Panel I; mid-septum, 34%; reference value 25–30%), while native T2 values were normal (Panel H). Late gadolinium enhancement revealed multiple nodular hyperenhancements in the LV septum (Panels J–L). Based on clinical and cardiac MRI findings, a diagnosis of hypertrophic cardiomyopathy (HCM) accompanied by LV apical septal diverticulum was established. Due to the challenges and uncertainties associated with closing the septal diverticulum, the patient was recommended to continue with medical therapy.