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2 Cases of Elusive Left Ventricular Outflow Tract Gradient
Alexandra Vaio Sykes1, Elizabeth Epstein1, Parnia Abolhassan Choubdar2
1Department of Internal Medicine, University of California-San Diego, San Diego, California, USA.
JACC. Case Reports
|November 17, 2022
Summary
Hypertrophic cardiomyopathy (HCM) can present subtly. Postprandial imaging is crucial for detecting left ventricular outflow tract gradients in suspected HCM cases, even with minimal septal hypertrophy.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Hypertrophic cardiomyopathy (HCM) is characterized by septal hypertrophy and left ventricular outflow tract (LVOT) gradients.
- These gradients are typically present at rest and can increase under specific hemodynamic conditions.
Purpose of the Study:
- To highlight the diagnostic value of postprandial imaging in specific hypertrophic cardiomyopathy cases.
- To emphasize the importance of considering subtle presentations of HCM.
Main Methods:
- Case report of two patients with hypertrophic cardiomyopathy.
- Utilized postprandial imaging to assess for LVOT gradients.
Main Results:
- Both patients exhibited subtle septal hypertrophy.
- LVOT gradients were only detected during the postprandial state, not at rest.
Conclusions:
- Subtle septal hypertrophy in HCM may present with gradients detectable only postprandially.
- Postprandial echocardiography should be considered in the diagnostic workup of suspected HCM, especially when resting gradients are absent.
Keywords:
HCM, hypertrophic cardiomyopathyLVOT, left ventricular outflow tractcardiomyopathyechocardiographyhemodynamicsimagingMore Related Videos
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