Variants of Hypertrophic Cardiomyopathy: A Registry Based Analysis of Twenty Cases

Mohammad Fakhrul Islam Khaled,

Abstract

Objective: The present research aimed at the careful evaluation of the different patterns, clinical presentation and establishment echocardiography as an authentic tool for diagnosis of Hypertrophic Cardiomyopathy (HCM) at an earlier stage. Methods: In this cross sectional study 20 patients were enrolled after taking informed consent. Initially all patients had presented with atypical chest pain where 10 patients presented with exertional shortness of breath and 4 patients presented with acute breathlessness. Initial ECG revealed T inversion in anterior-inferior leads and upright T wave in aVR. Patients were initially diagnosed accordingly as Chronic stable angina, Heart failure with preserve Ejection fraction (HFpEF), hypertesion and they underwent coronary angiogram (CAG) but CAG was normal in all patients. So, final evaluation of all patients done by repeat transthorasic echocardiography to find out the presence of any features of hypertrophic cardiomyopathy. Results: Among 20 patients, males (85%) were more than females (15%) with mean age 56 ± 3 years. All 20 patients were diagnosed as chronic stable angina, 4 patients with heart failure and 12 patients with hypertension initially. Baseline T inversion in anterior-inferior leads and upright T wave in aVR. Echocardiography and coronary angiogram were nirmal in all 20 patients. Repeat echocardiography showed that about two-thirds (13) of them had apical HCM where one-fifth (4) had lateral wall hypertrophy and less than one-fifth (3) had septal HCM. Conclusion: To minimize HCM related complications and earlier diagnosis, careful initial echocardiographic evaluation is an authentic tool.

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