2 Cases of Apical Hypertrophic Cardiomyopathy with Left Ventricular Endomyocardial Calcification

Jong Chun Park; In Jong Cho; Jung Pyung Seo; Moon Hee Ryu; Myung Kon Lee; Jong Soo Park; Gwang Chae Gill; Joo Hyung Park; Myung Ho Jeong; Jeong Gwan Cho; Jung Chaee Kang

doi:10.3803/jkes.1994.2.1.88

Journal List > J Korean Soc Echocardiogr > v.2(1) > 1075185

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Park, Cho, Seo, Ryu, Lee, Park, Gill, Park, Jeong, Cho, and Kang: 2 Cases of Apical Hypertrophic Cardiomyopathy with Left Ventricular Endomyocardial Calcification

Original Article

J Korean Soc Echocardiogr 1994;2(1):88-95.

Published online: 18 February 1994

DOI: https://doi.org/10.3803/jkes.1994.2.1.88

2 Cases of Apical Hypertrophic Cardiomyopathy with Left Ventricular Endomyocardial Calcification

Jong Chun Park, M.D., In Jong Cho, M.D., Jung Pyung Seo, M.D., Moon Hee Ryu, N.D., Myung Kon Lee, M.D., Jong Soo Park, M.D., Gwang Chae Gill, M.D., Joo Hyung Park, M.D., Myung Ho Jeong, M.D., Jeong Gwan Cho, M.D., Jung Chaee Kang, M.D.

Department of Internal Medicine Chonnam University Medical School, Kwangju, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Calcification of myocardium is most common in the site of an old infarction or in an aneurysmal wall. In addition, myocardial calcification may occur in association with endomyocardial fibrosis and hyperparathyroidism, as a result of focal toxic or inflammatory myocardial necrosis, as well as in patients undergoing hemodialysis. Calcium deposits due to parasites and due to neoplastic disease may also be seen. But left ventricular endomyocardial calcification associated with apical hypertrophic cardiomyopathy is very rare. This report describes 2 cases of apical hypertrophic cardiomyopathy with left ventricular endomyocardial calcification, diagnosed by the echocardiographic, angiographic and histologic findings.

Keywords: Apical hypertrophic cardiomyopathy, Endomyocardial calcification.

References

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Fig. 1.

Chest roentgenogram(A) and fluoroscopy(B) show curvilinear calcification within the heart shadow.

Fig. 2.

The ECG shows LVH with strain and giant negative T waves in V4–6.

Fig. 3.

Two-dimensional echocardiogram of the patient in the parasternal long axis view(A) and apical 4 chamber view(B). LV apex is markedly thickend and echogenic materials are scattered around the inner surface of LV apex.

Fig. 4.

The T1–201 image, transaxial view shows increased uptake in the LV apex.

Fig. 5.

Cardiac MRI shows signal void lesion in inner surface of LV apex.

Fig. 6.

Left ventriculogram(RAO view) shows globular shape of LV cavity during systole(A: systole, B: diastole).

Fig. 7.

The ECG shows LVH with strain and giant negative T waves in V3–6.

Fig. 8.

Two-dimensional echocardiogram of the patient in the parasternal long axis view(A) and apical 4 chamber view(B). LV wall thickness is markedly increased toward the apex and echogenic materials are scattered around the innner surface of LV apex.

Fig. 9.

The T1–201 image, transaxial view shows increased uptake in the LV apex.

Fig. 10.

Left ventriculogram(RAO view) shows globular shape of LV cavity during systole(A: systole. B: diastole).

Fig. 11.

Myocytes are surrounded by slightly increased interstitial fibrous tissue(hematoxylm-eosin. ×150).

Fig. 12.

Two myocytes(M) are separated by intervening collagenous fibrous tissue(C). A few attenuated cytoplasmic processes of fibroblasts(F) are seen. Some mitochondina in the myocytes undergo degenercetive fatty changes(arrow)× 24,000).

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