710934 research-article2017
CIC0010.1177/1179546817710934Clinical Medicine Insights: CardiologySaba et al
Histologic Sequelae of Apical Hypertrophic Cardiomyopathy: Dystrophic Calcification Shahryar G Saba1,2, John N Makaryus1, Navid Rahmani2 and Ram Jadonath1
Clinical Medicine Insights: Cardiology Volume 11: 1–2 © The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1179546817710934 https://doi.org/10.1177/1179546817710934
1Multimodality Cardiovascular Imaging Laboratory, Department of Cardiology, Hofstra Northwell School of Medicine, Manhasset, NY, USA. 2Multimodality Cardiovascular Imaging Laboratory, Department of Radiology, Hofstra Northwell School of Medicine, Manhasset, NY, USA.
ABSTRACT: We present cardiac computed tomography (CT) findings demonstrating apical hypertrophic cardiomyopathy with dystrophic calcification of the left ventricular apex. The absence of significant epicardial coronary artery disease demonstrated by coronary CT angiography suggests that increased wall tension and decreased microvascular perfusion over time account for the dyskinetic apical myocardium, rather than myocardial infarction secondary to atherosclerotic plaque rupture. These observations support CT as the imaging modality of choice to visualize the deposition of calcium in injured myocardial tissue, a recognized occurrence in chronically infarcted myocardium. Keywords: Hypertrophic cardiomyopathy, myocardial calcification, multidetector cardiac CT RECEIVED: February 6, 2017. ACCEPTED: April 16, 2017. Peer review: Five peer reviewers contributed to the peer review report. Reviewers’ reports totaled 545 words, excluding any confidential comments to the academic editor. Type: Image of Interest Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. CORRESPONDING AUTHOR: Shahryar G Saba, Multimodality Cardiovascular Imaging Laboratory, Department of Cardiology, Hofstra Northwell School of Medicine, 300 Community Drive, Manhasset, NY 11030, USA. Email: [email protected]
Case Report
A 76-year-old woman with atrial fibrillation, chest pain, dyspnea, and 1 prior episode of syncope presented to our medical center for pulmonary vein and coronary artery evaluation prior to an ablation procedure. Noncontrast cardiac computed tomography (CT) showed no coronary artery calcification, however, demonstrated circumferential myocardial calcification of the left ventricular apex (Figure 1). Coronary CT angiography showed minimal (
CIC0010.1177/1179546817710934Clinical Medicine Insights: CardiologySaba et al
Histologic Sequelae of Apical Hypertrophic Cardiomyopathy: Dystrophic Calcification Shahryar G Saba1,2, John N Makaryus1, Navid Rahmani2 and Ram Jadonath1
Clinical Medicine Insights: Cardiology Volume 11: 1–2 © The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1179546817710934 https://doi.org/10.1177/1179546817710934
1Multimodality Cardiovascular Imaging Laboratory, Department of Cardiology, Hofstra Northwell School of Medicine, Manhasset, NY, USA. 2Multimodality Cardiovascular Imaging Laboratory, Department of Radiology, Hofstra Northwell School of Medicine, Manhasset, NY, USA.
ABSTRACT: We present cardiac computed tomography (CT) findings demonstrating apical hypertrophic cardiomyopathy with dystrophic calcification of the left ventricular apex. The absence of significant epicardial coronary artery disease demonstrated by coronary CT angiography suggests that increased wall tension and decreased microvascular perfusion over time account for the dyskinetic apical myocardium, rather than myocardial infarction secondary to atherosclerotic plaque rupture. These observations support CT as the imaging modality of choice to visualize the deposition of calcium in injured myocardial tissue, a recognized occurrence in chronically infarcted myocardium. Keywords: Hypertrophic cardiomyopathy, myocardial calcification, multidetector cardiac CT RECEIVED: February 6, 2017. ACCEPTED: April 16, 2017. Peer review: Five peer reviewers contributed to the peer review report. Reviewers’ reports totaled 545 words, excluding any confidential comments to the academic editor. Type: Image of Interest Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. CORRESPONDING AUTHOR: Shahryar G Saba, Multimodality Cardiovascular Imaging Laboratory, Department of Cardiology, Hofstra Northwell School of Medicine, 300 Community Drive, Manhasset, NY 11030, USA. Email: [email protected]
Case Report
A 76-year-old woman with atrial fibrillation, chest pain, dyspnea, and 1 prior episode of syncope presented to our medical center for pulmonary vein and coronary artery evaluation prior to an ablation procedure. Noncontrast cardiac computed tomography (CT) showed no coronary artery calcification, however, demonstrated circumferential myocardial calcification of the left ventricular apex (Figure 1). Coronary CT angiography showed minimal (
