The occurrence of exercise-induced dynamic obstruction of the left ventricular outflow tract in patients without cardiomyopathy has recently been reported. However, it is not known if this phenomenon is a normal response to exercise in healthy adults. We studied 23 healthy adults using exercise Doppler echocardiography. We measured the left ventricular outflow velocity at rest and after maximum...

OBJECTIVES This study characterizes left ventricular outflow tract (LVOT) gradient variability in patients with hypertrophic cardiomyopathy (HCM) during cardiac catheterization. BACKGROUND Management of HCM is directed by the presence and magnitude of LVOT obstruction. The magnitude and clinical impact of spontaneous variability during a single cardiac catheterization has not been described. ...

Transcatheter aortic valves have been designed to treat elderly patients considered high-risk surgical candidates. Transcatheter aortic valve embolization represents a new complication previously unreported in the surgical bioprosthetic valve literature. We report the case of a 79-year-old male who successfully underwent aortic valve replacement after transcatheter aortic valve dislodgment into...

Aqueous humor flows out of the eye primarily through the conventional outflow pathway that includes the trabecular meshwork and Schlemm's canal. However, a fraction of aqueous humor passes through an alternative or 'unconventional' route that includes the ciliary muscle, supraciliary and suprachoroidal spaces. From there, unconventional outflow may drain through two pathways: a uveoscleral path...

The discrete form of subaortic stenosis is thought to be an acquired lesion, the aetiology of which may be a combination of factors which include an underlying genetic predisposition, turbulence in the left ventricular outflow tract, and various geometric and anatomical variations of the left ventricular outflow tract. A review of hypotheses relating to its aetiology is provided

Double tachycardia is a relatively rare condition. We describe a 21 year old woman with history of frequent palpitations. In one of these episodes, she had wide complex tachycardia with right bundle branch and inferior axis morphology. A typical atrioventricular nodal tachycardia was induced during electrophysiologic study, aimed at induction of clinically documented tachycardia. Initially no v...

Factors affecting water and nutrient outflow beyond the rooting zone were studied during a 3-yr period, using data from eight contrasting stands of lodgepole pine (Pinus contorta ssp. latifolia) forest in southeastern Wyoming and the output of a hydrologic simulation model (H20TRANS) based on tree physiology. Nutrient outflow during a specific time period was estimated by multiplying simulated ...

We report the case of a 41 years old woman who presented with massive bleeding after redo mitral valve replacement. A Left ventricular rupture, different from the three known types of wall rupture was hardly identified and controlled with extreme difficulty. The patient died eight days postoperatively due to disseminated intravascular coagulopathy. Retrospective analysis of the Echocardiograph...

A subaortic membrane predisposes to bacterial endocarditis usually affecting the aortic valve and left ventricular outflow tract. Endocarditis involving the subaortic membrane itself has been described twice only; once at operation and once at postmortem. The case of a man with vegetations involving a subaortic membrane that were detected preoperatively and the echocardiographic appearances of ...

Elevated intraocular pressure (IOP) is the predominant risk factor for glaucoma, and reducing IOP is the only successful strategy to prevent further glaucomatous vision loss. IOP is determined by the balance between the rates of aqueous humour secretion and outflow, and a pathological reduction in the hydraulic conductance of outflow, known as outflow facility, is responsible for IOP elevation ...