Related Experiment Video

Updated: Jun 23, 2026

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
10:08

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine

Published on: February 17, 2018

Syncope from dynamic left ventricular outflow tract obstruction simulating hypertrophic cardiomyopathy in a patient

José-Luis E Velazquez-Ceceña1, David L Lubell, Nagapradeep Nagajothi

  • 1Department of Cardiology, Mount Sinai Hospital Medical Center and the Chicago Medical School, California Avenue at 15th Street, Chicago, IL 60608, USA. joseluis_velazquez@hotmail.com

Texas Heart Institute Journal
|May 14, 2009
PubMed

Insights

In cardiac amyloidosis patients resembling hypertrophic cardiomyopathy, dynamic left ventricular outflow tract (LVOT) obstruction can cause syncope. This study highlights LVOT obstruction as a key cause of fainting in these complex cases.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Nephrology

Background:

  • Dynamic left ventricular outflow tract (LVOT) obstruction is a hallmark of hypertrophic cardiomyopathy.
  • Cardiac amyloidosis can mimic hypertrophic cardiomyopathy with asymmetric hypertrophy.
  • Syncope is frequent in cardiac amyloidosis but often attributed to other causes.

Observation:

  • A patient with primary AL-type amyloidosis presented with hypertrophic cardiomyopathy-like features and LVOT obstruction.
  • The patient experienced syncope attributed to dynamic LVOT obstruction.
  • Provocation of dynamic LVOT obstruction reproduced presyncope symptoms.

Findings:

  • Immunocyte-derived cardiac amyloidosis can cause dynamic LVOT obstruction.
  • Dynamic LVOT obstruction was identified as the cause of syncope in this patient.
  • Echocardiography revealed hypertrophic cardiomyopathy-like changes and LVOT obstruction.

Implications:

  • Dynamic LVOT obstruction should be considered in syncope evaluation for cardiac amyloidosis patients.
  • This finding expands the differential diagnosis for syncope in cardiac amyloidosis.
  • Understanding this mechanism can improve diagnostic accuracy and patient management.

Keywords:
Amyloidosis/classification/diagnosis/etiology/mortality/pathology/therapycardiomyopathies/complications/diagnosiscardiomyopathy, hypertrophic/diagnosisdiagnosis, differentialechocardiographyheart failure/etiologyprognosissyncope/etiology/physiopathologyventricular outflow obstruction/etiology

More Related Videos

Scanning Electron Microscopy of Macerated Tissue to Visualize the Extracellular Matrix10:21

Scanning Electron Microscopy of Macerated Tissue to Visualize the Extracellular Matrix

Published on: June 14, 2016

Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy 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...
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Imbalances in Cardiac Output01:26

Imbalances 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...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...