ABC Imagem Cardiovasc. 2026; 39(3): e20260090
Apical Hypertrophic Cardiomyopathy with Microfistulas: Correlation Between Coronary Flow Steal, Positive Inotropic Effect, and Normalization of T-Wave Polarity
José Sebastiao de , Tereza Cristina Pinheiro , Marília Esther Benevides , Isadora Sucupira Machado , Mateus Paiva Marques
DOI: 10.36660/abcimg.20260090i
Introduction
Apical hypertrophic cardiomyopathy (HCM) with microfistulas is a rare condition, and the incidence of multiple microfistulas draining into the left ventricle (LV) ranges from 0.07% to 0.09%., Diagnosis can be established via contrast ventriculography, coronary angiography, and echocardiography.–
Two-dimensional echocardiography with color and pulsed-wave Doppler allows visualization of microfistula flow and measurement of diastolic flow velocity (DFV) using the same approach as for the left anterior descending artery (LAD).
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Apical Hypertrophic Cardiomyopathy with Microfistulas: Correlation Between Coronary Flow Steal, Positive Inotropic Effect, and Normalization of T-Wave Polarity
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