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The plain chest X-ray of 12 patients with hypertrophic cardiomyopathy were found to be grossly abnormal and atypical of this disease. Four patients presented with enlarged globular shaped hearts suggesting dilatation of all cardiac chambers. In a further four this appearance was seen to develop over a period of years and four patients were found with marked left atrial enlargement. On reviewing the echocardiographic, angiographic and necropsy data it was noted that the cardiac enlargement was produced by dilation of the atria and the right ventricle but not the left ventricle.
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