Septal hyper-contractility is thought to be the principal cause of significant left ventricular outflow tract obstruction (LVOT) and systolic anterior motion (SAM) of the mitral valve by making the distance between the mitral valve and papillary muscle shorter. A seven-year-old patient with severe hypertrophic obstructive cardiomyopathy underwent direct interventricular septal myectomy/myotomy ...

OBJECTIVE To describe 11 patients with narrowing of the left ventricular outflow tract caused by angular posterior deviation of both the outlet septum and the upper part of trabecular septum, which was diagnosed by cross sectional echocardiography in all and confirmed by angiocardiography in seven. RESULTS Four patients had a subaortic systolic pressure gradient ranging from 23 to 70 mm Hg by...

Figure 1 – Panel A, extrinsic compression of the diagonal branch and septal branches (white arrows). Panel B, ventriculography of the right ventricle (RV) and left ventricle (LV), showing significant interventricular septal (IVS) hypertrophy during diastole and Panel C, LV outflow tract obstruction during end-systole. A 35-year-old man sought medical care for recurrent syncope episodes related ...

F ROM 1957 TO THE PRESENT, a total of 215 patients with tetralogy of Fallot underwent operations for total correction using extracorporeal circulation. Although the overall mortality rate was about 13 per cent. the rate decreased considerably during the 10 years. The most significant factors influencing the mortality rate were found to be the age of the patient when total correction was perform...

Despite the considerable morbidity and mortality associated with hypertrophic cardiomyopathy (HCM), proven therapeutic modalities for this disorder remain limited. The most feared complication, sudden death, usually due to ventricular tachyarrhythmias, can be averted by the use of implantable defibrillators, but patient selection for such procedures remains problematic. In recent years, evidenc...

Echocardiographic study was done on four pediatric patients with coexisting hypertrophic subaortic stenosis (HSS) and fixed left ventricular outflow (LVO) obstruction. One had valvar aortic stenosis, two had discrete subaortic stenosis and one had coarctation of the aorta. Preoperatively, HSS was not suspected in any of these patients because of the classical findings of fixed LVO obstruction. ...

Dynamic left ventricular outflow tract (LVOT) obstruction is a distinctive finding on echocardiography and often supports a diagnosis of hypertrophic obstructive cardiomyopathy (HOCM). It is also a clinical entity in its own right and is reproducible with stress. We describe a case of dynamic outflow obstruction in an elderly man with classical exertional symptoms. Echocardiography was used to ...

Background Interest has emerged in the evaluation of mitral valve morphology in patients with Hypertrophic Cardiomyopathy (HCM) and its contribution to left ventricular outflow tract obstruction (LVOTO). Specifically, elongation of the anterior mitral valve leaflet (AMVL) appears to be part of phenotypic expression in HCM and has been associated with severity of LVOT obstruction. However, the i...

BACKGROUND Nonobstructive hypertrophic cardiomyopathy (HCM) has been regarded as the predominant hemodynamic form of the disease on the basis of assessment of outflow gradient under resting conditions. We sought to prospectively define the prevalence, clinical profile, and significance of left ventricular (LV) outflow tract obstruction under resting conditions and with physiological exercise in...

BACKGROUND Some patients with Takotsubo cardiomyopathy (TTC) develop cardiogenic shock due to left ventricular outflow tract (LVOT) obstruction - there is, however, a paucity of data regarding this condition. METHODS Prevalence, associated factors and management implications of LVOT obstruction in TTC was explored, based on two-year data from two Belgian heart centres. RESULTS A total of 32...