ECG abnormalities in ~90%, but mostly nonspecific
High voltage ECG (which may produce abnormal T-waves)
LVH
Left atrial enlargement
Tall R-wave in V1, mimicking posterior MI
"Needle-like" Q waves, especially in lateral leads, mimicking infarction Q waves
CXR may be normal as LV is non-dilated
Echo
Unexplained wall thickness > 15 mm in any myocardial segment
Septal/posterior wall thickness ratio:
>1.3 in normotensive pts
>1.5 in hypertensive pts
Systolic anterior motion by M mode in PSL window, worsened by Valsalva
Mitral regurgitation
EF may be preserved until acute decompensation
Formal echo should include tissue Doppler imaging
High voltage ECG (which may produce abnormal T-waves)
LVH
Left atrial enlargement
Tall R-wave in V1, mimicking posterior MI
"Needle-like" Q waves, especially in lateral leads, mimicking infarction Q waves
Unexplained wall thickness > 15 mm in any myocardial segment
Septal/posterior wall thickness ratio:
>1.3 in normotensive pts
>1.5 in hypertensive pts
Systolic anterior motion by M mode in PSL window, worsened by Valsalva
Mitral regurgitation
EF may be preserved until acute decompensation
Formal echo should include tissue Doppler imaging
>1.3 in normotensive pts
>1.5 in hypertensive pts
Typically via echo
Hypertrophic cardiomyopathy
Seizure
Restrictive cardiomyopathy
Breath-holding spell
Dilated cardiomyopathy
Hyperventilation syndrome
Mitral valve prolapse
Pregnancy 