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The following electronic only articles are published in conjunction with this issue of Heart. Diagnosis of apical hypertrophic cardiomyopathy using magnetic resonance imaging T Ibrahim, M SchwaigerApical hypertrophic cardiomyopathy is an uncommon variant of non-obstructive hypertrophic cardiomyopathy with low prevalence outside East Asia. A case is reported of a non-Asian (European) 51 year old man with characteristic ECG and morphological changes of apical hypertrophic cardiomyopathy. Although the patient underwent catheterisation three years previously because of suggested coronary ischaemic heart disease, apical hypertrophic cardiomyopathy was not diagnosed. More recently, a regional wall motion abnormality was noticed at the apex on echocardiography. To rule out an ischaemic injury a stress perfusion scintigraphy was performed; no perfusion defect was present but an apical tracer enhancement was noted. Further evaluation by magnetic resonance imaging revealed the pathognomonic “ace of spades” configuration of the left ventricle with systolic obliteration of the apical region, which led to the diagnosis of apical hypertrophic cardiomyopathy. (Heart2000;83:e1)www.heartjnl.com/cgi/content/full/83/1/e1 A 72 year old woman with ALCAPA C Fierens, W Budts, B Denef, F van De WerfALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery), which causes the left coronary artery to grow with an anomalous origin from the pulmonary artery, is a rare disease which may result in myocardial infarction, congestive heart failure, and sometimes death during the early infantile period. A 72 year old woman with ALCAPA syndrome is presented. The asymptomatic patient presented with a cardiac murmur which was discovered during a routine check up for a gynaecological intervention. Coronary cineangiography established the diagnosis. Although surgical correction is the usual treatment for such cases, medical treatment was preferred for this patient because she was asymptomatic without clinical signs of heart failure. (Heart2000;83:e2)www.heartjnl.com/cgi/content/full/83/1/e2 Mycotic aneurysm of the ascending aorta following CABG M Prech, S Grajek, A Cieśliński, M Jemielity Mycotic aneurysm of the thoracic aorta is a rare and life threatening condition. Two patients are presented (both male, aged 66 and 59 years) in whom coronary artery bypass surgery was complicated by the development of a mycotic aneurysm. Fever preceded the radiological and echocardiographic signs of the aneurysm by at least several months in both cases. Blood cultures were negative for one patient and the source ofCorynebacterium sp infection in the other was not determined for several months. Both patients died before surgery could correct the aneurysm. (Heart2000;83:e3)www.heartjnl.com/cgi/content/full/83/1/e3
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