Hypertrophic cardiomyopathy is a common heritable cardiomyopathy with
various clinical phenotypes. A rare spiral variant has been recently
reported that has been associated with adverse outcomes and has
traditionally been diagnosed using cardiac magnetic resonance. We report
a case of the rare variant spiral hypertrophic cardiomyopathy where we
used transthoracic echocardiography with an ultrasound enhancing agent
to demonstrate the geometry of spiral hypertrophic cardiomyopathy and
compared to simultaneous cardiac MRI images. The use of echocardiography
with ultrasound enhancing agents may prove to be a valuable tool in
identifying the geometry of hypertrophic cardiomyopathy variants in
selected patients.