CIRCUMSCRIBED APICAL LEFT-VENTRICULAR HYP ERTROPHY AS A CAUSE OF MARKET T-WAVE NEGATIVITY IN THE PRECORDIAL LEADS

History and clinical findings: Two patients, one aged 57 the other 44 years, complained of nonspecific symptom-palpitation, left precordial pain and dyspnoea; There were no contributory findings on physical exa mination in both cases. Investigations: Both patients had hyperlipopro teinaemia, the younger one hyperuricaemia as well. The electrocardiogr am showed deeply negative symmetrical T waves in the precordial leads. Transthoracic and transoesophageal echocardiography demonstrated thic kening of the apical left ventricular wall. Coronary heart disease was excluded in both patients by coronary angiography. Treatment and cour se: The findings were fully explained to both patients. As they had on ly minor symptoms, no specific treatment was given. Conclusion: Isolat ed apical left ventricular hypertrophy should be considered as a possi ble cause of marked T-wave inversion in the precordial leads; this spe cial form of hypertrophic cardiomyopathy is rarely seen in Europeans. As autosomal dominant inheritance of this condition has been described in two families, other family members should be studied by echocardio graphy whenever this abnormality is found.