Related Experiment Video
Updated: May 31, 2026

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
Published on: August 17, 2022
Symptomatic hypertrophic obstructive cardiomyopathy: semi-supine bicycle ergometry as a useful provocative manoeuvre
Sanjay Kumar Dhar1, Vatchsala Varadharajan, Abdallah Al-Mohammad
1South Yorkshire Cardiothoracic Centre, Northern General Hospital, Herries Road, Sheffield, South Yorkshire S5 7AU, UK.
Abstract:
We report the case of a 58-year-old Caucasian woman with severe symptoms attributable to hypertrophic obstructive cardiomyopathy (HOCM). When supine there was no significant left ventricular outflow tract (LVOT) gradient on echocardiography or cardiac catheter measurements-despite provocation with supine leg exercise and right ventricular pacing. However, semi-supine bicycle exercise induced a marked increase in the LVOT gradient, which helped guide successful percutaneous alcohol septal ablation. This case report demonstrates the usefulness of bicycle exercise echocardiography in diagnosing HOCM with latent LVOT obstruction.
Related Concept Videos
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Cardiomyopathy V: Interprofessional Care
Cardiomyopathy II: Dilated Cardiomyopathy
Cardiomyopathy VII: Pre and Post Operative Nursing Management
Cardiomyopathy IV: Restrictive Cardiomyopathy
Mitral Stenosis II: Clinical features and Diagnostic Tests
