Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease. Its clinical expression is heterogeneous and its natural history can range from asymptomatic patient to sudden cardiac death (SCD) in young subjects. This complication in HCM is fortunately rare, is unpredictable and no preventive medical treatment has proven effective. Its complexity lies in identifying patients with a high-risk of SCD who could benefit from an ICD in primary prevention. Within these high-risk phenotypes are patients with apical aneurysm of the left ventricle.

This is a retrospective, descriptive and analytical study of cases of patients collected from the Radiology department of Rabat over the course of 4 years; between January 2015 and February 2019. These are generally known HCM patients, or referred with a suspicion of HCM on echocardiography, and thus sent to MRI to confirm the diagnosis, in which apical aneurysms were fortuitously discovered.

LV apical aneurysms were identified in 7 patients within a population of 139 HCM cases of all types. Our study focuses on the evaluation of this subgroup of patients, mainly: age, epidemiological parameters, clinical and electrical anomalies, echocardiographic and MRI study.

LV apical aneurysm patients represent an unknown subpopulation within a broad spectrum of HCM. Cardiac MRI is more effective in characterising both aneurysm and areas of contiguous myocardial fibrosis. Studies have shown that LV apical aneurysms complicating HCM are generally associated with an unfavourable clinical course. Consequently, the early diagnosis of these patients could change the prognosis.