Unusual flow patterns in a left ventricular aneurysm in hypertrophic cardiomyopathy: a case report

While paradoxical diastolic flow has been previously described in HCM with mid-ventricular obstruction, paradoxical bifid systolic jets have rarely been reported. These findings likely reflect transient pressure gradients between the contracting ventricle and the compliant aneurysm. The Yin-Yang Doppler pattern, more commonly associated with pseudoaneurysms, here reflected abnormal haemodynamics within a true aneurysm. This case highlights the importance of multimodality imaging not only for structural characterization and thrombus exclusion but also for identifying atypical intracavitary flow dynamics that may expand understanding of HCM pathophysiology.