A 2D echocardiogram shows increased wall thickness of the ventricular walls but normal left ventricular size. What type of myopathy might this indicate?

The situation described, where there is increased wall thickness of the ventricular walls with a normal left ventricular size, is highly indicative of hypertrophic myopathy. Hypertrophic myopathy, particularly hypertrophic obstructive cardiomyopathy (HOCM), is characterized by an abnormal thickening of the heart muscle, specifically the ventricular walls, without a corresponding increase in ventricular size. This thickening can lead to diastolic dysfunction and obstruction to outflow, but the overall chamber size remains normal, distinguishing it from other forms of cardiomyopathy.

In contrast, ischemic myopathy is typically associated with a history of coronary artery disease and may present with wall motion abnormalities rather than isolated thickening. Infiltrative myopathy involves a process of infiltration (such as amyloidosis), which can lead to wall thickening, but it often affects the overall function and may alter chamber sizes. Dilated myopathy is characterized by an enlarged left ventricle and reduced systolic function, which does not align with the normal size described in the question.

Thus, the pattern of increased wall thickness while maintaining normal overall ventricular size aligns best with hypertrophic myopathy, not infiltrative myopathy. Therefore, it’s essential to connect the echocardiographic findings