Fig. 6
From: Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings
Abnormalities of papillary muscles and mitral apparatus in classic HCM phenotype. a, 21-year-old woman with atypical chest and electrocardiographic abnormalities suggestive of HCM). End-diastolic two-chamber SSFP cine MR image shows isolated posterior papillary muscle hypertrophy (arrow) and myocardial trabeculations along the anterior LV wall and apex (arrowheads); b, 45-year-old woman with asymmetric septal HCM and anomaly of papillary muscle. Horizontal long-axis SSFP cine MR image at end-diastole shows bifid anterolateral papillary heads (arrowheads) and basal septal wall thickening (asterisk); c, 45-year-old man with chest pain. Short-axis SSFP cine MR image at end-diastole demonstrates multiple accessory papillary muscles, four in number (arrows), diffuse LV hypertrophy and pericardial effusion; d, 17-year-old man with myocardial hypertrophy limited to the basal ventricular septum. Horizontal long-axis SSFP cine MR image shows accessory left ventricular apical muscle bundle (arrowheads) traversing the LV cavity from the basal septal wall to the distal portion of the chamber