Reza Ghasemi - Department of Cardiology, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
Rasool Gharaee - Mashhad University of Medical Sciences, Mashhad, Iran
Susan Nazari - Department of Obstetrics and Gynecology, Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Shirin Sadri - Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran
Fahimeh Tehrani Zadeh - Department of Critical Care, Razavi Hospital, Imam Reza International University, Mashhad, Iran
Mohsen Yaghubi - Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran

Background: Hypertrophic cardiomyopathy (HCM) is defined by the presence of significant left ventricular hypertrophy (LVH) in the absence of secondary factors like systemic hypertension, aortic stenosis, and athlete's heart syndrome.Case presentation:A ۶۷-year-old woman, with a complaint of severe fatigue, peripheral cyanosis on normal daily activity life, and paroxysmal nocturnal dyspnea, was admitted to Cardiac Care Unit, Razavi Hospital, Mashhad, Iran. In the primary physical examination, cardiac auscultation revealed pathologic S۴ sound. Clinical investigations such as electrocardiography, chest X-ray, and echocardiography approved Apical Hypertrophic Cardiomyopathy (AHCM). Only administration of Metoprolol succinate with a short-term follow-up showed completely relieved pathologic presentation of this case.Conclusion:In this case report, the management of a patient with peripheral cyanosis on normal activity, paroxysmal nocturnal dyspnea, and AHCM was emphasized. This case showed that early diagnosis followed by medication and supportive care, can control the patient's symptoms and postpone the progression of heart failure symptoms.

Apical Hypertrophic Cardiomyopathy, Dyspnea, echocardiography