The ClinicianThe ClinicianКлиницист1818-83382412-8775Publishing House ABV Press16310.17650/1818-8338-2014-2-39-44CASE REPORTОПИСАНИЕ СЛУЧАЯCASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINICСЛУЧАЙ ДИАГНОСТИКИ АПИКАЛЬНОЙ ФОРМЫ ГИПЕРТРОФИЧЕСКОЙ КАРДИОМИОПАТИИ У ПАЦИЕНТКИ С КЛИНИКОЙ ПРОГРЕССИРУЮЩЕЙ СТЕНОКАРДИИKrylovaN. S.КрыловаН. С.
Russian Federation
DemkinaA. Ye.ДемкинаА. Е.
Russian Federation
ademkina@bk.ruKhashiyevaF. M.ХашиеваФ. М.
Russian Federation
KovalevskayaYe. A.КовалевскаяЕ. А.
Russian Federation
PoteshkinaN. G.ПотешкинаН. Г.
Russian Federation
VanyukovA. Ye.ВанюковА. Е.
Russian Federation
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, 1 Ostrovityanova St., Moscow, 117997, RussiaГБОУ ВПО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России, Россия, 117997, Москва, ул. Островитянова, 1City Clinical Hospital Fifty Two, Moscow Healthсare Department, 3 Pekhotnaya St., Moscow, 123182, RussiaГБУЗ «Городская клиническая больница № 52 Департамента здравоохранения г. Москвы», Россия, 123182, Москва, ул. Пехотная, 3150420148239443001201530012015Copyright ©; 2014, Krylova N.S., Demkina A.Y., Khashiyeva F.M., Kovalevskaya Y.A., Poteshkina N.G., Vanyukov A.Y.Copyright ©; 2014, Крылова Н.С., Демкина А.Е., Хашиева Ф.М., Ковалевская Е.А., Потешкина Н.Г., Ванюков А.Е.2014Krylova N.S., Demkina A.Y., Khashiyeva F.M., Kovalevskaya Y.A., Poteshkina N.G., Vanyukov A.Y.Крылова Н.С., Демкина А.Е., Хашиева Ф.М., Ковалевская Е.А., Потешкина Н.Г., Ванюков А.Е.https://creativecommons.org/licenses/by/4.0https://klinitsist.abvpress.ru/Klin/article/view/163

Objective of work: to describe the apical form of hypertrophic cardiomyopathy (AFHC) developing under the "mask" of the ischemic heart disease not diagnosed for a long period.

Materials and methods. Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG), echocardiography (EchoCG), Holter ECG monitoring, coronary angiography (CAG), ventriculography.

Results. The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV) hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6), EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg.), CAG (stenotic lesions of coronary arteries were found), ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicatesexpressed apical hypertrophy of the LV myocard). AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.

Conclusion. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.

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