Asymmetrical Septal Hypertrophy diagnosed by MRI: a case report

Abstract

Asymmetrical septal hypertrophy (ASH) is defined as an increase in ventricular wall thickness greater than 15 mm that is not associated with any other pathology. It is a condition that, in most cases, is caused by a mutation in one of the genes associated with the proteins that form the sarcomere. In this article, we present a case of ASH in a 43-year-old adult. After manifesting tachypnea, dyspnea, and cutaneous pallor, followed by a syncopal episode, the individual seeks medical attention. During the medical evaluation, an electrocardiogram (ECG) is performed, revealing bradycardia at 48 beats per minute and an inverted T wave in leads DI, AVL, V3, V4, V5, and V6. The diagnosis is confirmed through cardiac magnetic resonance imaging, which shows hypertrophic cardiomyopathy with non-obstructive ASH of 27.22 mm. Consequently, it is decided to initiate pharmacological treatment with propranolol, and the patient is still awaiting a surgical timeframe for the placement of an implantable cardioverter-defibrillator (ICD).