Introduction
Hypertrophic cardiomyopathy (HCM) is the most common heritable
cardiomyopathy, characterized by left ventricular (LV) hypertrophy, in
the absence of a secondary cause, with a typically asymmetric septal
hypertrophy and mid-cavity obliteration phenotype [1, 2]. Spiral
HCM, a rare variant, with a counter-clockwise rotation pattern of
myocardial hypertrophy, typically mandates diagnosis by cardiac magnetic
resonance (CMR) [3-7]. We report, to our knowledge, the first case
of a spiral variant HCM visualized using routine transthoracic
echocardiography (TTE). An ultrasound enhancing agent (UEA) allowed us
to identify its rare geometric phenotype.