From 1971-1981, 18 patients with discrete subaortic stenosis were treated surgically at the Medical University of South Carolina. Echocardiography was diagnostic in 10 of 11 patients in whom it was used. Preoperative cardiac catheterization was performed in all patients. The preoperative left ventricular outflow systolic pressure gradient was 82.0 +/- 27.2 mmHg (mean +/- SD) (range 30-145). In ...

A case of idiopathic hypertrophic subaortic stenosis (IHSS) associated with Wolff-Parkinson-White (WPW) syndrome is studied. On three occasions preexcitation was suppressed with an intravenous injection of ajmaline. The left ventricular outflow tract obstruction (LVOTO) was analyzed; when WPW syndrome activation disappeared, the obstruction decreased. The ventricular depolarization pathway is n...

In this study we explored the use of continuous wave Doppler echocardiography guided by simultaneous two-dimensional echocardiographic imaging as a method for noninvasively estimating pressure gradients in patients with discrete forms of left ventricular outflow tract obstruction. We studied 16 children, ages 6 months to 17 years, with valvular aortic stenosis (n = 12) or with discrete subaorti...

Over the past few years there has been a gradual recognition that obstruction to outflow from the left ventricle may be determined by lesions other than fusion of the aortic valve cusps or congenital diaphragms below or above the cusps. This syndrome has been described by Brock (1957, 1959), under the title of Functional obstruction of the left ventricle, and he instances a patient in whom hype...

Dynamic obstruction to left ventricular (LV) outflow as a result of mitral valve systolic anterior motion is a potentially deleterious facet of hypertrophic cardiomyopathy (HCM).1–4 In many patients, outflow obstruction is largely responsible for disabling symptoms of heart failure such as exertional dyspnea (often with chest pain), fatigue, and orthopnea.1,3 Consequently, treatment interventio...

A 66-year-old man presented with exertional dyspnea. He was found to have an unruptured aneurysm of the right sinus of Valsalva causing significant right ventricular outflow obstruction. This aneurysm was diagnosed by transthoracic two-dimensional echocardiography, transthoracic three-dimensional echocardiography, transesophageal echocardiography, contrast echocardiography and 64-slice multidet...

D ynamic obstruction to left ventricular (LV) outflow as a result of mitral valve systolic anterior motion is a potentially deleterious facet of hypertrophic cardiomyopathy (HCM).1-4 In many patients, outflow obstruction is largely responsible for disabling symptoms of heart failure such as exertional dyspnea (often with chest pain), fatigue, and orthopnea.ls3 Consequently, treatment interventi...

Percutaneous septal ablation has emerged as a less invasive treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). In the past decade, the availability of this sophisticated technique has revived the interest of cardiologists in left ventricular outflow tract obstruction, which led to the recognition that most patients with HCM have the obstructive type. Follow-u...