High left ventricular outflow tract gradient: Aortic stenosis, obstructive hypertrophic cardiomyopathy or both?

Area of Science:

• Cardiology
• Cardiovascular Imaging

Background:

• Hypertrophic cardiomyopathy and aortic stenosis are distinct cardiovascular conditions.
• Co-occurrence of these two conditions presents unique clinical scenarios.

Observation:

• A patient with clinical deterioration was investigated for complex cardiac symptoms.
• High-fidelity imaging, particularly transesophageal echocardiography, was crucial for diagnosis.
• A significant left ventricular outflow tract gradient was identified.

Findings:

• The patient was diagnosed with severe aortic stenosis co-existing with hypertrophic cardiomyopathy.
• Accurate diagnosis was challenging due to overlapping clinical presentations.

Implications:

• This case underscores the importance of advanced imaging in diagnosing complex cardiovascular diseases.
• Management strategies for patients with combined hypertrophic cardiomyopathy and aortic stenosis require careful consideration.