CBC, CMP, Thyroid Function panel, and urinalysis were WNL. GeneDx Hypertrophic Cardiomyopathy (HCM) Panel:
No disease-causing gene mutation was detected
Case Photo #2 EKG: sinus rhythm, prominent precordial voltage, “dome-shaped” convex ST segment elevations in the anterior precordial leads (V1-V2), and diffuse T wave inversions (most notably in the inferolateral leads).
Case Photo #3 2D Echo: Concentric LVH (maximal wall thickness of 1.6 cm) with speckled appearance of myocardium. Hyperdynamic global systolic function (EF > 75%). No LV outflow obstruction or systolic anterior motion of the mitral valve.
Case Photo #4 Cardiac MRI: Abnormal LV myocardial mass at 125 g/m˛ (47-87 g/m˛). Concentric LV thickening with slightly more prominent apical involvement (1.6 cm in anterior basilar septum and basilar inferolateral wall).
No abnormal uptake of gadolinium.
Case Photo #5 Stress ECHO: Standard Bruce protocol: Achieved predicted maximal HR without CP or SOB. Hypertensive response to exercise (baseline BP 152/73, HR 71; peak BP 220/ 60, HR 84), widespread repolarization abnormalities, and dynamic LV outflow tract obstruction
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