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Subaortic membrane mimicking hypertrophic cardiomyopathy.
Mark Joseph Anderson1, Adelaide Arruda-Olson2, Bernard Gersh2
1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
BMJ Case Reports
|November 6, 2015
Summary
A subaortic membrane caused symptoms mimicking hypertrophic cardiomyopathy (HCM). Surgical removal relieved symptoms and lowered left ventricular outflow tract (LVOT) velocity, highlighting the importance of considering this diagnosis.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Diagnostics
Background:
- Hypertrophic cardiomyopathy (HCM) is a common cause of left ventricular outflow tract (LVOT) obstruction.
- Patients may present with symptoms like angina and dyspnea refractory to medical management.
- Accurate diagnosis is crucial for appropriate treatment and patient outcomes.
Observation:
- A 34-year-old man presented with symptoms suggestive of HCM.
- Transthoracic echocardiography showed asymmetric septal hypertrophy but lacked typical HCM features.
- Elevated LVOT velocity and a subaortic membrane were identified as the cause of obstruction.
Findings:
- Coronary CT angiography confirmed the subaortic membrane and ruled out coronary artery disease.
- Surgical resection of the subaortic membrane and septal myectomy were performed.
- Postoperative TTE demonstrated significantly reduced LVOT velocities and symptomatic improvement.
Implications:
- Subaortic membrane should be considered in the differential diagnosis of LVOT obstruction mimicking HCM.
- Accurate identification of the obstruction's cause is vital for effective surgical intervention.
- This case underscores the importance of comprehensive echocardiographic evaluation and advanced imaging for complex cardiac conditions.
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