We present a Mediterranean female patient with abnormal electrocardiog
raphic findings and a history of shortness of breath during excessive
effort (NYHA I) in whom apical hypertrophic cardiomyopathy with unusua
l features was detected by echocardiography and magnetic resonance ima
ging. There was a single fused apical hypertrophic papillary muscle an
d akinesia of the left ventricular apical segment. Abnormal left ventr
icular filling was also detected by Doppler echocardiography.