Published online Sep 6, 2023. doi: 10.12998/wjcc.v11.i25.5970
Peer-review started: May 22, 2023
First decision: July 6, 2023
Revised: July 11, 2023
Accepted: July 31, 2023
Article in press: July 31, 2023
Published online: September 6, 2023
Processing time: 102 Days and 3.3 Hours
Apical hypertrophic cardiomyopathy (AHCM) is a subtype of hypertrophic cardiomyopathy. Due to its location, the thickening of the left ventricular apex can be missed on echocardiography. Giant negative T waves (GNTs) in left-sided chest leads are the hallmark electrocardiogram (ECG) change of AHCM.
The first patient was a 68-year-old woman complaining of recurrent chest tightness persisting for more than 3 years. The second was a 59-year-old man complaining of spasmodic chest tightness persisting for more than 2 years. The third was a 55-year-old woman complaining of recurrent chest pain persisting for 4 mo. In all three cases, GNTs were observed several years prior to apical cardiac hypertrophy after other causes of T-wave inversion were ruled out.
Electrophysiological abnormalities of AHCM appear earlier than structural abnormalities, confirming the early predictive value of ECG for AHCM.
Core Tip: Apical hypertrophic cardiomyopathy (AHCM) is a subtype of hypertrophic cardiomyopathy that is thought to be associated with sudden death. Owing to its atypical clinical symptoms and insidious progression, early diagnosis is difficult. We followed up three patients who eventually progressed to AHCM over a period of several years. Giant negative T waves in the left-sided chest leads of these three patients occurred earlier than thickening of the left ventricular apex as detected via echocardiography. Therefore, we suggest that electrophysiological abnormalities in AHCM appear earlier than structural abnormalities and that electrocardiogram may have early predictive value for AHCM.