Pseudo-normalization of deep T-wave inversions in a patient with apical hypertrophic cardiomyopathy when presenting as apical ballooning syndrome.

Hiten Patel, Rahul Vasudev, Up

Abstract

Differential diagnosis of T wave inversions in anterolateral leads includes acute coronary syndrome, intracranial hemorrhage or apical hypertrophic cardiomyopathy (HCM). Later is a rare variant of HCM that usually involves the apex of the left ventricle. Takotsubo cardiomyopathy (TCM) or transient left ventricular (LV) apical ballooning syndrome is a clinical entity mimicking an acute coronary syndrome and characterized by reversible LV dysfunction that is frequently precipitated by a stressful event either emotional or physical stress. We present a case of a 48 year old male with apical HCM that developed TCM causing pseudo-normalization of the baseline T wave inversions. Through this case authors suggest that TCM can cause apical ballooning and can mask the typical ECG changes as seen in patients with apical HCM.

Relevant Publications in Journal of Cardiovascular Medicine and Therapeutics