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Apical hypertrophic cardiomyopathy: what are the risks in our diverse military population?
  1. Leanne Jane Eveson1 and
  2. A Williams2
  1. 1 Chelsea and Westminster Hospital, London, UK
  2. 2 Cardiology Department, Royal Gwent Hospital, Newport, UK
  1. Correspondence to A Williams, Cardiology Department, Royal Gwent Hospital, Newport NP20 2UB, UK; awilliams1282{at}gmail.com

Abstract

We present the case of a 50-year-old, fit, asymptomatic gurkha officer. At a routine medical, an ECG showed T-wave inversion in the chest leads V3–6. Transthoracic echo showed left ventricular apical hypertrophy and cavity obliteration consistent with apical hypertrophic cardiomyopathy (ApHCM). Cardiac magnetic resonance imaging showed apical and inferior wall hypertrophy in the left ventricle with no aneurysm or scarring. A 24-hour monitor showed normal sinus rhythm with no evidence of non-sustained ventricular tachycardia. Eighteen-panel genetic testing revealed no specific mutations. Cardiopulmonary exercise testing demonstrated a V̇O2 max, anaerobic threshold and peak V̇O2 consistent with above average cardiopulmonary capacity. There was no family history of either ApHCM or sudden cardiac death (SCD). Risk of SCD by the European Society of Cardiology’s HCM calculator was low. This case generates discussion on the prognosis of ApHCM, factors that worsen prognosis, occupational limitation considerations and appropriate monitoring in this patient group.

  • apical hypertrophic cardiomyopathy
  • cardiomyopathies
  • prognosis
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Footnotes

  • Contributors Both authors contributed to the writing of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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