Apical hypertrophic cardiomyopathy (ApHCM), or Yamaguchi syndrome, is a morphological variant of hypertrophic cardiomyopathy that frequently mimics acute coronary syndrome (ACS) due to ischemic-type chest pain and characteristic electrocardiographic changes. A 46-year-old woman presented with angina and deep T-wave inversion in precordial leads. Coronary angiography showed normal epicardial arteries. Transthoracic echocardiography revealed localized left ventricular apical hypertrophy with preserved systolic function and the typical "ace-of-spades" cavity configuration, confirming ApHCM. She was managed conservatively with beta-blockers and guideline-directed therapy, with symptomatic improvement. Early recognition prevents unnecessary invasive procedures and facilitates appropriate long-term management.
Keywords: acute coronary syndrome, apical hypertrophy cardiomyopathy, chest pain syndrome, giant t-wave inversion, yamaguchi syndrome
Cureus
Case Reports
English
42181339
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