Innocent left ventricular outflow tract membrane masquerading as vegetation

Area of Science:

• Cardiology
• Medical Imaging
• Neurology

Background:

• Innocent left ventricular outflow tract (LVOT) membranes are rare congenital anomalies.
• They are often discovered incidentally during echocardiographic examinations.
• Differentiating these membranes from pathological conditions like valvular vegetations is crucial.

Observation:

• A patient presented with symptoms of an ischaemic stroke.
• Initial transthoracic echocardiography suggested a possible valvular vegetation as the embolic source.
• The patient was treated with anticoagulation and antibiotics based on this initial finding.

Findings:

• Subsequent transesophageal echocardiography provided a clearer view, reclassifying the structure as an innocent LVOT membrane.
• The initial diagnosis of valvular vegetation was revised.
• The patient's treatment with anticoagulation and antibiotics was discontinued.

Implications:

• This case underscores the importance of advanced imaging techniques like transesophageal echocardiography in accurate cardiac diagnosis.
• Misdiagnosis of an LVOT membrane can lead to unnecessary and potentially harmful treatments.
• Long-term follow-up confirmed the benign nature of the LVOT membrane, with no complications observed over five years.