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The diagnosis of apical hypertrophic cardiomyopathy with myocardial perfusion imaging
  1. Hayan Jouni1,
  2. Jeffrey B Geske2,
  3. Todd D Miller2
  1. 1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
  2. 2Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Hayan Jouni, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Jouni.Hayan{at}

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Case description

A 67-year-old male with a history of hypertension, dyslipidaemia, diabetes mellitus type 2, obstructive sleep apnoea and obesity was referred for evaluation of an abnormal ECG. At presentation, the patient was asymptomatic and denied prior cardiac symptoms. Resting 12-lead ECG demonstrated marked ST and T-wave abnormalities consistent with anterolateral ischaemia (Figure 1A). On single-photon emission CT myocardial perfusion (SPECT) wall motion images, the left ventricular chamber was noted to have a peculiar ‘spade-shaped’ contour (Figure 1B,C, online supplementary media clip 1). On this basis, a transthoracic …

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  • Contributors All authors participated in the preparation and review of this manuscript.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Mayo Clinic IRB.

  • Provenance and peer review Not commissioned; internally peer reviewed.