Figure 41

Development and progression of left ventricular hypertrophy in children with HCM. Upper panel: Development of marked hypertrophy of the anterior basal ventricular septum (VS). M-mode echocardiograms shown here were obtained at the same cross-sectional level in a girl with a family history of HCM. At age 11, ventricular septal thickness was at upper limit of normal (10 mm); at age 15, septal thickness had increased markedly (to 33 mm), and appearance of the echocardiogram is typical of JCM. The patient remained asymptomatic throughout this period of time but died suddenly and unexpectedly at age 17. PW= posterior left ventricular free wall.
Lower panel: Dynamic, striking changes in left ventricular wall thickness with age in 22 children, each patient is represented by the left ventricular segment that showed the greatest change in wall thickness. Open symbols denote five patients who had no evidence of hypertrophy in any segment of the left ventricle at the initial evaluation but subsequently developed de novo hypertrophy typical of HCM.

(From BJ Maron et al: N Engl J Med 315:610, 1986)

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