Quadricuspid Pulmonic Valve, Pulmonary Artery Aneurysm, and Apical Hypertrophic Cardiomyopathy
A Rare Combination
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A 67-year-old man presented with complaints of intermittent episodes of mild exertional dyspnea and substernal chest pain that improved by resting. He had a history of essential hypertension, cigarette smoking, moderate congenital pulmonic stenosis, and severe pulmonary artery dilatation. Physical examination showed a grade 3 systolic murmur in the apex and left upper sternal border, without other anomalies. His diagnostic work-up included an ECG that demonstrated left ventricular hypertrophy and inverted T waves in the anterolateral leads (particularly in leads V4 and V5), as well as a stress echocardiogram without evidence of ischemia and with moderate-to-severe thickening of …