Apical hypertrophic cardiomyopathy: Is it a conundrum for Gated SPECT MPI?

Apical hypertrophic cardiomyopathy, AHCM, is common in Japanese and Chinese populations but uncommon in western population and in IndoPak subcontinent. AHCM patients tend to have milder symptoms; however, in up to one-third cases, myocardial infarction, left ventricular aneurysm formation, atrial and ventricular arrhythmias and strokes may develop. Echocardiography and cardiac MRI are the good modalities for diagnosis. Gated SPECT myocardial perfusion imaging is a good alternative for diagnosis due to well defined scan patterns in AHC. A case of AHCM is presented and the subject is briefly reviewed.