Myocardial crypts, currently investigated as a potential morphological marker of HCM, are commonly present in gene carriers and can be identified in minority of patients who developed hypertrophy as well. CMR is the preferred method for the detection of crypts and many authors discourage the use of 2D echocardiography due to its lower spatial resolution.
Nevertheless, the sensitivity of CMR in crypt detection is largely dependent on protocol used and can be significantly increased when modified projections are added to standard long-axis planes. Based on our experience, we suggest that, with optimal window, myocardial crypts may be detected even with TTE.