Double chamber left ventricle associated with severe form of hypertrophic cardiomyopathy

Abstract

In a 28-month-old girl, from a normal pregnancy and absolutely healthy parents, weighing 16.3 kg, a systolic murmur was noted during a routine pediatric examination and she was referred for cardiological examination at tertiary level. The child’s growth and development were completely normal. Her arterial blood gas level was within normal limits. The clinical examination demonstrated: a quiet precordium, normal first heart sound, short midsystolic murmur 2-3/6 degree on the apex and left sternal border, and a single second heart sound. The electrocardiogram showed: left axis deviation, and biventricular hypertrophy. A chest radiogram revealed an enlarged cardiac silhouette with a narrow mediastinum. Echocardiography demonstrated: normal systemic and pulmonary vein connections, with reduced interatrial communication. There were normal atrio-ventricular and ventriculo-arterial connections. From an apical four-chamber view, symmetric hypertrophy of the left ventricle was demonstrated during diastole, and a subaortic obstruction, together with interventricular septal hypertrophy and thickening. In addition, the echocardiographic examination revealed 2 DOUBLE CHAMBER LEFT VENTRICLE ASSOCIATED WITH SEVERE FORM OF HYPERTROPHIC CARDIOMYOPATHY