Yamaguchi Syndrome: A Case of Apical Hypertrophic Cardiomyopathy in a Patient From West Africa

Hypertrophic cardiomyopathy is the most common genetic cardiomyopathy. The apical variant, also known as Yamaguchi syndrome, is a rare condition that is reportedly more prevalent in Asian populations. It is characterized by hypertrophy predominantly limited to the left ventricular apex, with a classic "ace of spades" shaped left ventricular cavity. We present a 61-year-old male of West African descent with a chest pain syndrome and deep inverted precordial T-waves on 12-lead electrocardiography. Two-dimensional echocardiography demonstrated focal left ventricular hypertrophy limited to the apex, and speckle-tracking imaging showed reduced apical strain, findings consistent with apical hypertrophic cardiomyopathy (HCM). Risk assessment for sudden cardiac death was low. A previous invasive coronary artery angiography reported normal epicardial coronary arteries. The patient was started on carvedilol 6.25 mg orally twice daily, with resolution of the chest pain and, so far, a generally optimal quality of life after four months of follow-up.