1/7 This 56 yo was the first patient I saw in clinic this morning. EKG reminded of my friend professor Sakamoto, who first described giant negative T waves in 1976 of apical HCM. #echofirst 
2/7 Apical LAX view demonstrating marked apical hypertrophy.
3/7 Despite LVEF of 70%, the indices of myocardial mechanics are markedly reduced, better predictors of adverse outcomes.
4/7 Cardiac MR with delayed gadolinium enhancement showed diffuse extensive myocardial enhancement in the apical as well as in the mid LV segments. #CardiacMR #CMR
6/7 @fuadfehmi @AAH_StLukesCV @ACCinTouch @ASE360 @CircImaging @MarthaGrogan1 @adnanalkhouli @JaeKOh2 @BijoyKhandheria @Lakshmi14524052 @renujain19 @PatrycjaGalazka @mahali87 #echofirst #cardiotwitter #CardiacMR
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