A Shifting Cardiomyopathy: Transition Between Stress and Apical Variant Hypertrophic Cardiomyopathy: A Case Report

Cardiomyopathies span a broad range of phenotypic expression and contribute to systolic and diastolic heart failure. In the present case, a previously healthy woman presented with a typical stress cardiomyopathy. Her hospital stay was uncomplicated and there was predictable resolution of LV function. Several months later, she elected to have left atrial appendage occlusion. Her case was complicated by a pericardial effusion due to a wire micro perforation. Repeat echocardiography weeks later revealed an apical variant hypertrophic cardiomyopathy with associated EKG changes. These echocardiographic and electrocardiographic abnormalities normalized in the months following. This represents a transient phenotype switching between a stress and apical variant HCM with possible novel genetic propensities for both.