The effect of nifedipine on the ejection flow pattern in the left ventricular outflow tract was observed using pulsed Doppler echocardiography in 6 patients with hypertrophic cardiomyopathy. After sublingual administration of nifedipine (10 mg) to 1 patient, the turbulent ejection flow pattern became more marked and increased in duration compared with the initial state. An increase in turbulenc...

AIMS This study investigated the clinical and physiological significance of the dynamic left ventricle outflow gradient observed in some patients during dobutamine stress echocardiography. METHODS Three hundred and ninety-four consecutive patients completed dobutamine stress echocardiography using Doppler echocardiography to assess the presence of myocardial ischaemia and left ventricular out...

Left ventricular outflow tract obstruction (LVOTO) is an important source of morbidity and mortality after repair of atrioventricular septal defect (AVSD). The intrinsic anatomy of the left ventricular outflow tract in AVSD is complex and predisposes to the development of LVOTO. LVOTO after repair of AVSD usually involves multiple levels and sources of obstruction, and surgical intervention mus...

Although considerable information is available concerning the clinical features and natural history of asymmetric septal hypertrophy (ASH) in adults, little is known of this disease in children. The clinical characteristics and course of 46 children with ASH, who were evaluated at the National Heart and Lung Institute, have been analyzed. Twenty-four children had obstruction to ventricular outf...

A 63-year old man with a significant left ventricular outflow obstruction due to an aberrant sub-valvular mitral tissue (not characteristic of a classical subaortic web; Fig. 1a and b), underwent resection of the mass and septal myectomy through a trans-aortic approach (Fig. 1c). Postoperative echocardiography demonstrated a reduction in the subaortic resting gradient of 70%, with no evidence o...

Twenty patients with idiopathic hypertrophic subaortic stenosis (IHSS) were studied with cardiac echography. Eight of these patients were studied during left heart catheterization. The echographic pattern of mitral valve motion during systole was altered in a characteristic manner when hemodynamically significant left ventricular outflow obstruction was present in the eight patients studied at ...

Hypertrophic cardiomyopathy is a prevalent genetic disease characterized by left ventricular hypertrophy, presenting dynamic obstruction of outflow tract with subaortic gradient happening at rest in 30% of the cases. It is attributed to the intricate interaction between the anterior mitral leaflet, the interventricular septum and altered flow vectors generated in left ventricle along with chang...

T HE INTRAVENTRICULAR pressure gradients that are recorded in patients with idiopathic hypertrophic subaortic stenosis (IHSS) differ in many respects from those observed in patients with the various discrete forms of obstruction to left ventricular outflow. Thus, it is now generally recognized that the magnitude of the pressure gradient measured in the resting state may bear little relation to ...