APICAL HYPERTROPHIC CARDIOMYOPATHY

We report the case of a patient with recurrent admissions for congesti ve heart failure who was subsequently diagnosed with apical hypertroph ic cardiomyopathy. The major physiologic characteristic of patients wi th apical hypertrophic cardiomyopathy is diastolic dysfunction due to abnormal stiffness of the left ventricle during diastole, with resulta nt impaired ventricular filling. In these patients, as in all patients with hypertrophic cardiomyopathy, the main pathology is inadequate re laxation of the ventricle; therefore, a regimen of diuretics and inotr opic agents can actually worsen the clinical picture. We emphasize the need to consider hypertrophic cardiomyopathy in evaluating cases of c ongestive heart failure.