Phonoechocardiographic identification of chordal snap in hypertrophic cardiomyopathy

Area of Science:

• Cardiology
• Cardiac Imaging
• Acoustic Cardiology

Background:

• Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition.
• Systolic murmurs are common in HCM, but specific acoustic events require further investigation.

Purpose of the Study:

• To investigate the origin of a late systolic click in patients with hypertrophic cardiomyopathy.
• To correlate acoustic findings with echocardiographic evidence of chordal motion.

Main Methods:

• Case series involving three patients diagnosed with hypertrophic cardiomyopathy.
• Utilized M-mode and two-dimensional echocardiography to assess cardiac structures and motion.
• Performed phonoechocardiographic studies to precisely time the systolic click in relation to cardiac events.

Main Results:

• A late systolic click was consistently observed following a mid-systolic murmur in all three patients.
• Echocardiography demonstrated systolic anterior motion (SAM) of the chordae tendineae in every patient.
• Phonoechocardiography confirmed that the click's timing coincided with the cessation of mild anterior chordal motion.

Conclusions:

• The late systolic click in these hypertrophic cardiomyopathy patients is likely a 'chordal snap'.
• Systolic anterior motion of the chordae tendineae is a key echocardiographic finding associated with this acoustic event.
• Phonoechocardiography is valuable in characterizing the temporal relationship between cardiac mechanics and audible sounds in HCM.