Apical hypertrophic cardiomyopathy: a case report

Apical hypertrophic cardiomyopathy (AHC) is a rare variant of hypertrophic cardiomyopathy characterized by thickening of the most distal part of the left ventricular (LV) wall. It was first described by Sakamoto in 1976 in Japanese patients. AHC was reported as a striking electrocardiographic pattern of giant negative T-waves and angiographic feature of end diastolic LV cavity configuration resembling an ace of spade by Yamaguchi et al. Although AHC is more common in Asia and it accounts for about 13% to 25% of all cases of hypertrophic cardiomyopathy, it is much less prevalent in the western population. Diagnostic modalities include ECG, echocardiography, ventriculography, nuclear myocardial perfusion studies and cardiac magnetic resonance imaging.We present a 58-year-old man with AHC that was unrecognized for the previous 10 years. In conclusion, this rare disease could be found in the Croatian population too, whereas the appropriate interpretation of the ECG and echocardiography is crucial in recognizing this rare, but important form of hypertrophic cardiomyopathy.