A 2D echocardiogram shows increased wall thickness of the ventricular walls but normal left ventricular size. What type of myopathy might this indicate?

• A. Ischemic myopathy
• B. Infiltrative myopathy
• C. Hypertrophic myopathy
• D. Dilated myopathy

Answer: (C)

Increased wall thickness of the ventricular walls combined with a normal size of the left ventricle is characteristic of hypertrophic myopathy, specifically hypertrophic cardiomyopathy (HCM). This condition is defined by an abnormal thickening of the heart muscle, particularly the septum and free walls of the ventricles, which can lead to impaired cardiac function and potentially arrhythmias.

In HCM, even though the walls are thickened, the overall size of the left ventricle remains within normal limits, which differentiates it from other types of myopathies, such as dilated myopathy, where the ventricle is typically enlarged with thinning of the walls.

Recognizing these features in a 2D echocardiogram allows clinicians to identify hypertrophic cardiomyopathy, making it an essential consideration when evaluating patients with symptoms of heart failure, syncope, or family history of cardiac disease.