Fig. 2

Representative cases of patients with unexplained giant T-wave inversions on electrocardiogram (ECG). Patient 1 (a–d) a 59-year-old male and is a typical case from Group 1. a and b show the two chamber and 4 chamber end-diastolic balanced steady state free precession (bSSFP) cine images respectively at baseline. c and d were the corresponding 2 and 4 chamber end-diastolic bSSFP cine images at follow-up 48 months later when this patient fulfilled criteria for apical HCM. Patient 2 (e–h) is a 57 years-old male and represents a typical case from Group 2. e and f show the 2 chamber and 4 chamber end-diastolic bSSFP cine phases respectively at baseline. f and g show the 2 and 4 chamber cine views, respectively, 32 months later. The wall thickness of apex has become became (average 35% increased) when compared to baseline, however the absolute value does not meet the diagnostic criteria for apical HCM