Incidental detection of apical hypertrophic cardiomyopathy by myocardial perfusion imaging

Methods We present three cases of HCM predominantly involving the cardiac apex, whose diagnosis was first suspected on myocardial perfusion imaging. These patients were referred for chest pain syndromes to exclude significant coronary artery disease. All were undiagnosed on initial routine transthoracic echocardiography, and none were specifically suspected by the referring clinicians. All cases underwent an adenosine stress rest Tc-99m tetrofosmin myocardial perfusion protocol, and were subsequently referred for transpulmonary contrast echocardiography.