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Figure 2 Development of hypertrophic cardiomyopathy (HCM) phenotype in adulthood. Stop-frame two-dimensional echocardiograms at end- diastole, at the papillary muscle level in the parasternal short-axis plane, from a woman with familial HCM at age 27 years, when genotyping was initiated (A), and at age 33 years, after myosin-binding protein C mutation was known (B). (A) Left ventricular (LV) thickness is normal ( 12 mm) in all segments of the wall, including the ventricular septum (VS). (B) Six years later, at age 33, wall thickness was abnormally increased (19 to 20 mm) in the anterior ventricular septum (AVS) and posterior septum (PVS), as well as the anterolateral free wall (AFW). Mild mitral valve systolic anterior motion (without septal contact or outflow gradient) appeared at this time, although it is not shown here. Calibration marks are 10 mm apart.
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