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Anomalous papillary muscle producing dynamic left ventricular outflow tract obstruction
C A Roldan1, F T Gurule, B K Shively
1Cardiology Section, Veterans Administration Hospital, Albuquerque, NM 87108.
Summary
An anomalous papillary muscle was identified as the cause of a patient's dynamic left ventricular outflow murmur. Doppler echocardiography confirmed this finding, revealing abnormal left ventricular hemodynamics due to the muscle's position.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Anatomy
Background:
- Dynamic left ventricular outflow murmurs can have various etiologies.
- Accurate diagnosis is crucial for understanding cardiac hemodynamics.
Observation:
- A patient presented with a dynamic left ventricular outflow murmur.
- Transthoracic and transesophageal two-dimensional Doppler echocardiography were utilized for imaging.
Findings:
- An anomalous anterolateral papillary muscle was identified as the cause of the murmur.
- High late systolic outflow velocity and systolic anterior motion were observed.
- The Venturi effect was suggested as a contributing factor due to the anomalous muscle's location.
Implications:
- This study provides the first Doppler echocardiographic confirmation of an anomalous papillary muscle affecting left ventricular hemodynamics.
- Highlights the utility of advanced echocardiography in diagnosing complex cardiac conditions.
- Offers insights into the mechanisms of dynamic outflow murmurs.