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Detection of apical hypertrophic cardiomyopathy by cardiovascular magnetic resonance in patients with non-diagnostic echocardiography
  1. J C C Moon1,
  2. N G Fisher1,
  3. W J McKenna2,
  4. D J Pennell1
  1. 1Centre for Advanced Magnetic Resonance in Cardiology (CAMRIC), Royal Brompton Hospital, London, UK
  2. 2Department of Cardiological Sciences, St George’s Hospital Medical School, London, UK
  1. Correspondence to:
    Professor Dudley J Pennell
    Royal Brompton Hospital, 3 Sydney Street, London SW3 6NP, UK;


Objective: To investigate the role of cardiovascular magnetic resonance (CMR) in a series of patients with ECG repolarisation changes and normal echocardiography.

Patients and design: 10 patients with anterolateral T wave inversion for which there was no obvious pathological cause who had normal routine echocardiography without contrast for the exclusion of hypertrophic cardiomyopathy (HCM) also had CMR that was diagnostic of apical HCM.

Results: Apical HCM detected by CMR could be morphologically severe with wall thickness up to 28 mm, or mild. The extent of repolarisation abnormalities did not correlate to the morphological severity.

Conclusions: In patients with unexplained repolarisation abnormalities, a normal routine echocardiogram without contrast does not exclude apical HCM. Further imaging with CMR or contrast echocardiography may be required. The reliance on routine echocardiography to exclude apical HCM may have led to underreporting of this condition.

  • cardiovascular magnetic resonance
  • echocardiography
  • apical hypertrophic cardiomyopathy

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