Abstract

Apical hypertrophic cardiomyopathy (ApHCM) is relatively uncommon variant of hypertrophic cardiomyopathy which typically influences the left ventricular apex. We report a case of a 64-year-old Caucasian male who presented to the ER with pain in his chest (angina) and diaphoresis, diagnosis of ApHCM was reached. The variable presentation, clinical course of the disease and limited literature among Caucasian population creates a challenge in detecting it and results in delayed or missed diagnosis, however by spotting its characteristic features on electrocardiography (the “giant” negative precordial T‐waves) and the “ace of spades” configuration on echocardiogram as well as using cardiac catheterization and cardiac MRI, diagnosis can be confirmed. This particular case will underscore the infrequent occurrence of ApHCM in Caucasians, along with the its complex diagnostic and presentation characteristics it produces.

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