Fig. 4
From: Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings
Distribution of myocardial hypertrophy in classic HCM phenotype. a, 56-year-old man with symmetric myocardial hypertrophy. End-diastolic two-chamber SSFP cine MR image shows diffuse and symmetric LV wall hypertrophy (asterisks); b, 43-year-old man who presented with palpitations. Short-axis SSFP cine MR image at end-diastole shows asymmetric septal wall hypertrophy (arrows); c, 57-year-old man with severe dyspnea. End-diastolic four-chamber SSFP cine MR image demonstrates a “dumbbell” configuration of the LV cavity with midventricular myocardial thickening (asterisks), marked muscular midcavity systolic constriction and a thin-walled apical aneurysm (arrow). d, Four-chamber LGE MR image clearly depicts the enhanced thinned apical LV aneurysm (arrows) extending from the aneurysm rim into the septum and free wall (arrowheads). Global systolic function also decreased because the ejection fraction was 35%; e, 53-year-old woman with apical HCM. End-diastolic horizontal long-axis SSFP MR image demosntrates the spade-like appearance of LV chamber secondary to apical LV hypertrophy; f, 22-year-old man with right ventricular hypertrophy. Short-axis SSFP cine MR image at end-diastole shows a prominent right ventricular structure that inserts directly on the anterior ventricular septum corresponding to large hypertophied crista supraventicularis muscle (arrowheads)