Electrocardiographical case. Asymptomatic patient with deep T-wave inversions

Ting P, Gunasegaran K, Teo WS
Correspondence: Dr Peter Ting, pting33@hotmail.com

ABSTRACT
A 45-year-old man was found to have an abnormal myocardial perfusion scan. He was asymptomatic, with no chest pain, breathlessness or palpitations. Clinical examination was unremarkable. The 12-lead electrocardiography (ECG) showed increased QRS voltage in leads V3-V6, and deep T-wave inversions noted in leads V3-V6, with an absence of septal Q waves. These ECG features were characteristic of apical variant hypertrophic cardiomyopathy (HCM). He underwent a coronary angiogram that revealed normal coronary arteries, and a left ventriculogram which showed apical HCM. Transthoracic echocardiography further confirmed the diagnosis. No drug therapy was instituted as he was asymptomatic. Apical HCM is discussed.

Keywords: apical hypertrophy, hypertrophic cardiomyopathy, Japanese variant hypertrophic cardiomyopathy, T-wave inversion, transthoracic echocardiography
Singapore Med J 2007; 48(6): 586–589