What are the findings of hypertrophic cardiomyopathy on MRI?
Hypertrophic cardiomyopathy is inherited as an autosomal dominant trait with variable penetrance. Genotype positive patients may be asymptomatic or have atrial fibrillation, heart failure, syncope, or even sudden cardiac death. Asymmetric hypertrophy of the ventricular wall can occur anywhere with variable phenotype. Systolic anterior motion of the mitral valve and left ventricular outflow tract obstruction can also be seen. MRI is useful for diagnosis and treatment planning by identifying the distribution of the thickened myocardium, maximum wall thickness, and late enhancement, and for quantifying the subaortic pressure gradient ( Figure 12-11 ). LGE is helpful to predict prognosis as well as to differentiate this condition from other disorders that may cause abnormal myocardial wall thickening.