Isolated papillary muscle hypertrophy: A variant of hypertrophic cardiomyopathy? Do not miss a hypertrophic cardiomyopathy

摘要

A 66-year-old male with a history of surgically closed secundum type atrial septal defect (ASD) during childhood and a percutaneous coronary intervention complained of recurrent stable angina. Clinical investigation and 12-lead ECG were unremarkable. He was referred for hybrid myocardial perfusion SPECT (SPECT) and 64-slice CT coronary angiography (CCTA). SPECT showed normal perfusion of the left ventricle (LV) and an enlarged right ventricle (RV). Gated images showed a decreased LV ejection fraction of 50% due to septal wall motion abnormalities suggestive of RV overload. Prospectively ECG-triggered CCTA revealed minor coronary atherosclerosis and a patent stent.