Echocardiography and cardiac MRI in mutation-negative hypertrophic cardiomyopathy in an older patient: a case defining the need for ICD

Echocardiography. 2014 Aug;31(7):E204-6. doi: 10.1111/echo.12614. Epub 2014 May 10.


We report the case of a 67-year-old man with hypertrophic cardiomyopathy who presented for a second opinion about implantable cardio-defibrillator (ICD) placement after a witnessed syncopal episode. Despite his older age, being mutation-negative, and having a maximal septal thickness of 2.2 cm on echocardiography, he demonstrated rapid progression of myocardial fibrosis on cardiac MRI, correlating to ventricular tachyarrhythmias and syncope. We review the role of echocardiography and cardiac MRI in optimizing medical care for such patients who may not otherwise meet criteria for an ICD placement or further interventions.

Keywords: cardiac MRI; echocardiography; hypertrophic cardiomyopathy.

Publication types

  • Case Reports

MeSH terms

  • Ablation Techniques / methods
  • Aged
  • Cardiomyopathy, Hypertrophic / diagnostic imaging
  • Cardiomyopathy, Hypertrophic / pathology
  • Cardiomyopathy, Hypertrophic / therapy*
  • Contrast Media
  • Defibrillators, Implantable*
  • Echocardiography / methods*
  • Follow-Up Studies
  • Gadolinium
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Mutation
  • Myocardium / pathology*
  • Treatment Outcome


  • Contrast Media
  • Gadolinium