[Congestive, hypertropic cardiomyopathy--intermediary form of primary myocardial disease? (author's transl)].

A 43-year-old woman with anginal pain and the electrocardiographic signs of an old anterior infarction presented the clinical, hemodynamic and angiographic findings of congestive cardiomyopathy. Left ventricular (LV) end-diastolic volume was sizably increased, there was generalized hypokinetic wall motion and LV ejection fraction was reduced to 40 percent. The subsequent clinical course was characterized by progressive congestive heart failure and the patient died 4 years after the first appearance of symptoms. Autopsy revealed marked dilatation of all heart chambers and severe hypertrophy of the LV anterior wall. The LV posterior wall and the septum were less markedly hypertrophied. Light and electron microscopy showed the typical findings of hypertrophic cardiomyopathy in the anterior part of the LV wall whereas the septum and the LV posterior wall presented unspecific histological alterations. In conclusions, this case demonstrates that a clinically typical congestive cardiomyopathy may be associated with a localized area characteristic for hypertrophic cardiomyopathy. Thus it is a postulated that the described patient represents an intermediary form of primary myocardial disease.