The Clinical Observation And Analysis Of Apical Hypertrophic Cardiomyopathy

Background and ObjectiveThere are small number cases of apical hypertrophic cardiomyopathy (AHCM) in western countries.However AHCM makes up 25% of the total cases in the Japan. In our country, the AHCM case is increasing in recent years, although there few cases of the AHCM reported in the past time. Thus, to sum up the points which we have just indicated, the AHCM is the common case in the Asians. In the electrocardiogram of AHCM, T wave shape in precordial lead is low and flat. And some T wave shape like the coronary T wave, the most obvious are T-wave of precordial lead of V3 V4,W5,V6. The ST segment may be compressed 3～4mm, and it is also obvious in precordial lead. At present, some patients of AHCM are diagnosed with unstable angina pectoris or non-ST segment elevated myocardial infarction. If mastering skilled and knowledgeable about that electrocardiogram properties of AHCM, it will heighten our vigilance about AHCM and diagnose AHCM combination with some advanced detecting and monitoring techniques, such as echocardiography, radionuclide myocardial perfusion imaging or non-invasive nuclear magnetic resonance.It's necessary to make Cardiac catheterization ventriculography to patient who apical hypertrophic gently change,it make the patient be able to cure in time. The purpose of the present study is evaluaton the clinical and imaging features of AHCM, moreover, enhance reliably diagnosis on AHCM.MethodsThis article analyzed the previous investigation, there are 8 cases diagnosised AHCM confirmed by the clinical symptoms,clinical signs,biochemical, electrocardiogram and imaging examinations of patients. There are 2 cases are confirmed in January,2002-January,2003, The Third Hospital of Beijing University; 3 cases in January,2008-June,2010, The First Affiliated Hospital of Zhengzhou University; 3 cases in January,2004-June,2010, The People's Hospital of zhongmou, Honan Province.ResultAll cases with AHCM have the Clinical symptoms about Palpitations, shortness of breath, and Occasionally precordial dull pain.The main sings of heart are that: Hair-like noise in 2/6 level Systolic at Apical; No significant expansion of Heart community; 1 case patient can be heared 1/6-2/6 level Systolic hair-like noise at aortic valve Second auscultation area.The main signs of ECG are that:precordial (V3-V5) T wave inversion (0.45-2.2) mV, precordial (V3-V5) ST segment depression, precordial (V3-V5) R wave higher amplitude Significantly, some of the cases have abnormal Q wave.Ultrasound cardiogram check show that all cases 1 have the Clinical symptoms of Left ventricular apex (below the level of papillary muscle) hypertrophy,the average thickness is 18.11±4.20mm.The ultrasound cardiogram have the value of clear diagnosis. If the diagnosis is difficult,the heart MR and LV inspection could be taken examination.Some patients show increased serum cholesterol and low density lipoprotein.ConclusionsIn Clinical,when the patients with the ECG-free have V3-V5 lead R wave amplitude increased with Deep symmetrical T wave inversion, To a high degree of consider and possibility of the AHCM. The ultrasound cardiogram have the value of clear diagnosis,if the diagnosis is difficult,the heart MR and LV inspection or examination could be taken.