Related Experiment Video
Updated: Jun 24, 2026
07:11
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Provokable left ventricular outflow tract obstruction in a patient without hypertrophy
Ferdinando Pasquale1, Maria Teresa Tomé-Esteban, Riccardo Morgagni
1The Heart Hospital, London, UK.
Nature Reviews. Cardiology
|April 9, 2009
Summary
A 61-year-old man experienced exertional chest pain and shortness of breath. Investigations revealed provokable left ventricular outflow tract obstruction, managed with medication and a pacemaker.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- A 61-year-old male presented with exertional dyspnea and chest pain.
- Past medical history included hiatus hernia and a family history of ischemic heart disease.
Observation:
- The patient underwent extensive investigations including physical examination, electrocardiography, echocardiography, cardiopulmonary exercise testing, coronary angiography, transesophageal echocardiography, and stress echocardiography.
- Provokable left ventricular outflow tract obstruction was diagnosed.
Findings:
- The left ventricular outflow tract obstruction was present without electrocardiographic abnormalities or left ventricular hypertrophy on echocardiography.
- Pharmacological management with atenolol and disopyramide was initiated.
- Dual-chamber pacemaker implantation was performed.
Implications:
- This case highlights the importance of considering left ventricular outflow tract obstruction in patients with exertional symptoms.
- Multimodality imaging and testing are crucial for diagnosis.
- A combination of pharmacological therapy and pacing can effectively manage this condition.
More Related Videos
Related Concept Videos
01:22Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:27Mitral Valve Prolapse I: Introduction
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...