Enlarged Image for Hypertrophic Cardiomyopathy

Echocardiographic still frames from the apical long-axis. Note the massively enlarged papillary muscle inserting directly into the anterior mitral leaflet (arrows). The left image is a diastolic frame and the right image is a systolic frame. There is obstruction caused by the hypertrophied papillary muscle at the mid-cavity level in this patient. LA = left atrium, LV = left ventricle, RV = right ventricle.