The Research Of Clinical Feature And Electrocardiogram And Correlated Imageology To Apical Hypertrophic Cardiomyopathy

Objective: To investigate the clinical feature, electrocardiogram and correlated imageology of apical hypertrophic cardiomyopathy (AHCM).To reduce the missed diagnosis and misdiagnosis of the disease .Methods: The clinical signs and symptoms, biochemical, coronary angiogr -aphy and left ventricular angiography result, especial about electrocardiogram and echocardiogram characteristics of 31 AHCM(17 examples from the Guang xi medical college first affiliated hospital since January 1997 to October 2008, 14 examples from the Guangxi Zhuang Autonomous Region people hospital since January 1997 to October 2008)were retrospectively reviewed. And selected 31 examples of normal echocardiogram result to comparison and analysis with this group of apical hypertrophic cardiomyopathy patient.Results: The clinical symptoms of 31 cases AHCM were chest stuffy and the palpitation, the short of breath; The physical sign of heart was no specificity. Electrocardiogram showed T wave inversion (0.1～2.8) mV in V3～V5, ST segment depression in above leads (0.05～0.4) mV, R wave amplitude in V3～V5 lead increased obviously; and abnormal Q wave was not observed in left apical hypertrophic cardiomyopathy cases. Echocardiogram showed left ventricular apex hypertrophy (free wall of left ventricle and/or inter ventricular septum below the level of pilliary muscle) in 28 examples, The average thickness is 18.08±3.92 mm, and the thickness may reach 28 mm at most . There are non-statistics significance of the LVDd,LVDs,FS,LVEF,SV. 21 examples have carried on the Coronary angiography inspection, 17 examples are normal, 4 examples have the coronary artery to be narrow. 9 examples carried on left ventricular angiography, including 5 cases in left ventricular angiography had the apical"spade"changes.The biochemistry were basically normal.Conclusions: The diagnosis of AHCM should depend on diagnostic changes of electrocardiogram and echocardiogram, When electrocardiogram showed T wave inversion in V3～V5 and R wave amplitude in V3～V5 lead increased obviously, we must consider AHCM highly. The characteristic in the ECG are the important signs for clinical diagnosis of AHCM. UCG is a basic check and notice the apical hypertrophy. When diagnosis is difficult, we should choice others way as Coronary angiography and left ventricular angiography and magnetic resonance. It has important value in diagnosing AHCM.