TY - JOUR A2 - Pepe, Alessia AU - Morita, Yusuke AU - Kato, Takao AU - Okano, Mitsumasa AU - Su, Kanae AU - Kimura, Masahiro AU - Minamino, Eri AU - Nakane, Eisaku AU - Izumi, Toshiaki AU - Miyamoto, Shoichi AU - Haruna, Tetsuya AU - Inoko, Moriaki PY - 2014 DA - 2014/06/25 TI - A Rare Case of Hypertrophic Cardiomyopathy with Subendocardial Late Gadolinium Enhancement in an Apical Aneurysm with Thrombus SP - 780840 VL - 2014 AB - The mechanisms responsible for the development of apical aneurysms in cases of hypertrophic cardiomyopathy (HCM) are currently unclear but likely involve multiple factors. Here, we present a case of HCM with marked subendocardial fibrosis involving the apical and proximal portions of the left ventricle. A 71-year-old man with left ventricular hypertrophy presented with signs and symptoms of heart failure. The presence of asymmetrical left ventricular hypertrophy and bilateral, thickened ventricular walls with an apical aneurysm on transthoracic echocardiography suggested a diagnosis of HCM with ventricular dysfunction. No intraventricular pressure gradients with obstruction were identified. Late gadolinium enhancement (LGE) with cardiac magnetic resonance imaging and endomyocardial biopsies showed subendocardial fibrosis involving the apical aneurysm and proximal portion. Whereas LGE in a transmural pattern is commonly observed in HCM apical aneurysms, subendocardial LGE, as noted in the present case, is a relatively rare occurrence. Thus, the present case may provide unique insights into the adverse remodeling process and formation of apical aneurysms in cases of HCM. SN - 2090-6862 UR - https://doi.org/10.1155/2014/780840 DO - 10.1155/2014/780840 JF - Case Reports in Radiology PB - Hindawi Publishing Corporation KW - ER -