Apical Hypertrophic Cardiomyopathy Variant of HCM.Predominantly effects the apex of the heart.Note the “Ace-of- Spades” appearance in the apical 4 and 2 chamber views characteristic of Apical HCM. Post author:Dan Durocher Post published:October 21, 2019 Post category:Echo / Echo Bank / Pericardial, Myocardial, Pulmonary, Congenital Heart Disease