APICAL HYPERTROPHIC CARDIOMYOPATHY RELEVANCE, DIAGNOSIS, AND MANAGEMENT: A NIGERIA AND WEST AFRICA NARRATIVE

Apical hypertrophic cardiomyopathy (ApHCM) is a distinct and often under-recognized phenotype of hypertrophic cardiomyopathy characterized by disproportionate left ventricular apical hypertrophy, giant T-wave inversion, and, in some patients, apical aneurysm, arrhythmia, or thromboembolic risk. Although ApHCM has been studied extensively in Asian and selected Western cohorts, evidence from West Africa remains sparse, and the condition is frequently obscured by overlapping phenotypes such as hypertensive heart disease and endomyocardial fibrosis. This review synthesizes current evidence on the epidemiology, clinical presentation, imaging phenotype, differential diagnosis, risk stratification, and management of ApHCM, with attention to diagnostic barriers in Nigeria and the broader West African region. We highlight the added value of focused echocardiographic protocols, contrast imaging, and cardiac magnetic resonance in improving case detection and risk assessment, and we discuss how regional infrastructure constraints shape real-world practice. By integrating global evidence with local diagnostic realities, this review aims to provide a practical framework for earlier recognition, more accurate phenotyping, and context-appropriate management of ApHCM in under-resourced settings.