APICAL HYPERTROPHIC CARDIOMYOPATHY OF THE JAPANESE TYPE COEXISTENT WITH A CORONARY MUSCLE BRIDGE - A CASE-REPORT AND REVIEW

We describe the case of a 21-year-old Italian male who presented with giant negative T-waves and left ventricular hypertrophy on the electro cardiogram suggestive of apical hypertrophic cardiomyopathy. Clinicall y, he suffered from new onset of exertional angina, dyspnea and palpit ations during soccer playing or heavy exercise beginning one week befo re admission. Echocardiography and cardiac catheterization confirmed t he rare combination of a nonobstructive apical hypertrophic cardiomyop athy of the ''Japanese'' type coexistent with an extensive muscular br idge involving almost the entire anterior interventricular branch of t he left coronary artery. Although the patient complained of exertional angina pectoris, absence of objective evidence of myocardial ischemia by means of treadmill stress test, exercise thallium scan, dobutamine stress echocardiography as well as atrial pacing stress emphasized th e benign nature of this complex anomaly.