This composite educational graphic illustrates the longitudinal progression of hypertrophic cardiomyopathy (HCM) to dilated cardiomyopathy (DCM) in a patient with an ELAC2 mutation. The image consists of three sequential stages (A-B, C-D, and E-F) utilizing electrocardiograms (ECG) and echocardiograms (four-chamber views).

This composite diagnostic image displays three transthoracic echocardiography frames (labeled a, b, and c) from patients with familial hypertrophic cardiomyopathy (FHCM). All three grayscale B-mode images demonstrate significant asymmetric hypertrophy of the left ventricle, primarily involving the ventricular septum. Panel (a) shows a septum thickness of 2.38 cm in a 27-year-old female; panel (b) shows 2.18 cm in a 68-year-old male; and panel (c) displays a massive septal thickness of 3.36 cm in an 84-year-old female. Image (c) additionally incorporates color Doppler imaging, showing turbulent, high-velocity blood flow (manifested as mosaic blue, red, and green signals) within the left ventricular outflow tract, which is characteristic of obstructive hypertrophic cardiomyopathy. These images are clinically significant for illustrating pathognomonic structural remodeling associated with MYBPC3 gene mutations, emphasizing the role of ultrasound in measuring maximum wall thickness and assessing hemodynamic obstruction in cardiomyopathy patients.

This set of four transthoracic echocardiogram (TTE) images illustrates different phenotypic manifestations of Hypertrophic Cardiomyopathy (HCM). Panel A shows a Parasternal Long Axis (PLAX) view demonstrating asymmetric septal hypertrophy (ASH), where the interventricular septum (IVS) is significantly thicker than the posterior wall (ratio > 1.3). Panel B displays massive septal hypertrophy with a diastolic thickness exceeding 30 mm. Panel C utilizes color Doppler to show the clinical consequences of massive hypertrophy, specifically demonstrating Right Ventricular Outflow Tract (RVOT) obstruction caused by the septal bulge into the right ventricle. Panel D illustrates Mid-Ventricular Obstructive Hypertrophic Cardiomyopathy (MOHC), characterized by an 'hourglass' shaped left ventricle. This morphology creates two distinct chambers: a dilated proximal chamber with a bulging basal septum and a distal chamber, which in this case represents an apical aneurysm. These diagnostic images are essential for identifying risk factors for sudden cardiac death and planning surgical or medical management in cardiology.

Gross pathology photograph of a human heart obtained from a 53-year-old female with hypertrophic cardiomyopathy. Modality: Gross pathology photography; specimen is a fixed, whole-heart cross-section. Anatomical orientation reveals a transverse cut through the ventricles revealing markedly thickened left ventricular walls and an enlarged, fibrous interventricular septum with reduction of the left ventricular cavity. Epicardial adipose tissue is variably present along the outer surface. Internal papillary muscles are visible, and the right ventricle shows relatively preserved wall thickness compared with the hypertrophied left ventricle. The myocardial wall appears densely myocardiac with homogeneous pale to tan coloration consistent with fixation. The image scale bar indicates 1 cm for reference. The gross morphology is typical of hypertrophic cardiomyopathy, where asymmetric septal hypertrophy can cause decreased LV cavity volume and potential outflow tract obstruction; however, assessment of obstruction requires echocardiography or MRI. This specimen demonstrates the hallmark feature of disproportionate septal thickening relative to the posterior wall. Clinically, hypertrophic cardiomyopathy elevates risk for arrhythmias, syncope, and sudden cardiac death, particularly in middle-aged patients. The image is useful for educational illustration of cardiac remodeling in HCM, correlating macroscopic anatomy with underlying myocardial disarray and genetic etiologies. Relevant for pathology, cardiology, and medical education contexts worldwide.

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This clinical imaging figure consists of three serial posteroanterior (PA) chest radiographs (labeled A, B, and C) illustrating the progression and resolution of acute pulmonary edema. Image A (At admission) shows relatively clear lung fields with visible vascular markings and a cardiac silhouette demonstrating mild cardiomegaly, but no active parenchymal disease. Image B (Pulmonary edema) captures a hypertensive emergency state, characterized by significant bilateral air space opacifications, perihilar haze (bat-wing distribution), and obscured costophrenic angles consistent with pleural effusions. Interventional artifacts, including ECG leads and potentially a central venous catheter or monitoring lines, are visible. Image C (Post treatment) demonstrates marked clinical improvement following diuretic and vasodilator therapy, showing near-complete resolution of the bilateral opacities and restoration of lung field lucency. This series serves as a diagnostic comparison for identifying radiographic signs of acute heart failure and pulmonary congestion, emphasizing the dynamic changes in pulmonary vasculature and alveolar aeration during treatment.