Myocardial crypts

Myocardial crypts (or myocardial clefts or fissures) refer to discrete clefts or fissures in otherwise compacted myocardium of the left ventricle. They are thought to represent a distinctive morphological expression of hypertrophic cardiomyopathy, occurring with different frequency in these patients with or without left ventricular hypertrophy.

Terminology

They are usually defined as invaginations penetrating >50% of the thickness of adjoining compact myocardium usually perpendicular to the long axis of the left ventricle, tending to narrow or occlude in systole and without local hypokinesia or dyskinesia.

Epidemiology

While they can be present in the normal population but increasingly common in those with hypertrophic cardiomyopathy and hypertensive cardiomyopathy .

Differential diagnosis

Possible imaging differential considerations include: