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    Includes Expert Content
    Angiogram Result
    Mycardio posted:
    My angiogram after a recent MI indicated no significant coronary artery disease, but, "Evidence of a significant gradient between the apical segment and the mid segment of the left ventricle with no difference in the pressure between the LVOT and the aorta." This was attributed to possible, "segmental hypertrophy cardiomyopathy." What does that mean?

    I am 75. I had chronic pericarditis as a young man and had a pericardectomy when I was 27. My MI was indicated by chest pain, an abnormal ECG, and elevated troponin and CK-MB.
    James Beckerman, MD, FACC responded:
    Hypertrophic cardiomyopathy is characterized by an abnormal thickening in some or all of the heart muscle that can also be associated with symptoms at rest or with exertion, as well as abnormal heart rhythms.

    Some people may have thickening and increased squeezing of a particular part of the heart that may result in a pressure difference within the heart between different areas.

    It may make sense to discuss further with your doctor to see if an echocardiogram (ultrasound of the heart) would be useful in visualizing your heart muscle more clearly (as an angiogram helps to visualize the cavity rather than the walls themselves).
    Mycardio replied to James Beckerman, MD, FACC's response:
    Hi, Dr. Beckerman;

    Thanks for your response. I've done some research since I posted my question and your response is consistent with what I've learned. Nevertheless, I'm still curious as to the cause of the thickening. I described my experience and medical history on my blog ( ).

    Given my history of pericarditis, I'm wondering whether: (1) the thickening has occurred gradually over the years due to recurrent episodes of inflammation; and (2) whether the thickening is due to episodes of myocarditis. Can you offer any advice on how this might be determined?

    Thanks again.

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