Clinical manifestation of apical hypertrophic cardiomyopathy by syncope in the elderly

The authors present a rare phenotype of hypertrophic cardiomyopathy (HCM) in an elderly patient with apical HCM and syncope. A 71-year-old female patient admitted to the cardiology department with complaints of sudden feeling of palpitations, weakness, dizziness, short-term loss of consciousness. Electrocardiography revealed signs of left ventricular (LV) hypertrophy, deep negative T waves in precordial leads. The maximum thickness of apical LV segment was 16.2 mm, and systolic LV cavity configuration resembled the card sign «spade». A 24-hour monitoring revealed supraventricular and ventricular premature beats and short paroxysm of atrial fibrillation. The features of this case are HCM diagnosed in elderly age and syncope as immediate cause of hospitalization and final diagnosis.