Rapid Progression of Left Ventricular Hypertrophy
Patients with hypertrophic cardiomyopathy sometimes develop extreme hypertrophy in the left ventricle. A 78-year-old woman showed rapid progression of left ventricular hypertrophy. She was referred to our hospital at the age of 73 years because of left ventricular hypertrophy on seen on ECG. Screening echocardiography demonstrated that the maximum wall thickness of the interventricular septum was 14 mm (Movie I). The wall thickness had increased to 37 mm in 5 years (Movie II), despite the absence of any cardiac or systemic disorder that could cause hypertrophy. Histopathological examinations of the ventricular endomyocardium demonstrated myocardial hypertrophy and myofibrillar disarray without other significant abnormalities (Figures 1 and 2⇓). The patient died suddenly from a ruptured aneurysm of the thoracic aorta 9 months later. An autopsy confirmed the diagnosis of hypertrophic cardiomyopathy.
The online-only Data Supplement, which contains 2 movies, can be found at http://circ.ahajournals.org/cgi/content/full/114/9/e368/DC1.