Larriva Ana María, Uvera Sandra Rosales, Vásquez Zuilma, Fernández Beatriz, Azanza Diego Xavier Chango
Servicio de Cardiología, Clínica Santa Ana, Cuenca, Ecuador. Servicio de Cardiología Clínica Santa Ana Cuenca Ecuador.
Servicio de Imagen Cardiovascular, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Cuidad de México, Mexico. Servicio de Imagen Cardiovascular Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán Cuidad de México Mexico.
Arch Peru Cardiol Cir Cardiovasc. 2023 Jun 30;4(2):78-82. doi: 10.47487/apcyccv.v4i2.289. eCollection 2023 Apr-Jun.
Apical hypertrophic cardiomyopathy (ApHCM) can result in the formation of a left ventricular apical aneurysm and progressive myocardial fibrosis, which is associated with a worse prognosis. We present the case of a 76-year-old man previously diagnosed with ApHCM seven years ago, who has been under clinical follow-up. Serial cardiac magnetic resonance (CMR) imaging was performed in 2013 and 2020 due to suspected apical aneurysm formation based on echocardiographic evaluation. The 2020 CMR imaging revealed an increase in myocardial fibrosis observed through late-gadolinium enhancement images and, for the first time, a small apical aneurysm that was not clearly visualized on two-dimensional echocardiography. The time course leading to the development of an ApHCM aneurysm is not well-defined and may impact the clinical course.
心尖肥厚型心肌病（ApHCM）可导致左心室心尖部动脉瘤形成及进行性心肌纤维化，这与较差的预后相关。我们报告一例76岁男性病例，该患者七年前被诊断为ApHCM，一直在接受临床随访。基于超声心动图评估怀疑有心尖部动脉瘤形成，于2013年和2020年进行了系列心脏磁共振（CMR）成像检查。2020年的CMR成像显示，通过延迟钆增强图像观察到心肌纤维化增加，并且首次发现了一个二维超声心动图未清晰显示的小型心尖部动脉瘤。导致ApHCM动脉瘤发生的时间进程尚不明确，可能会影响临床病程。
