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Cardiomyopathy III: Hypertrophic Cardiomyopathy

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
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Mitral Valve Prolapse I: Introduction01:27

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IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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Mitral Stenosis I: Introduction01:22

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Mitral Regurgitation I: Introduction01:20

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Atypical Left Ventricular False Chordae Tendineae.

Amr Darwish1, Priscilla Wessly1, Nadeen Faza1

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A rare left ventricle false tendon was identified in a patient undergoing evaluation for mitral valve repair. This anatomical variation could potentially complicate transcatheter edge-to-edge repair procedures.

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3-dimensional transesophageal echocardiographyLV false chordLV false tendonchordae tendineaemitraclip

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Area of Science:

  • Cardiovascular medicine
  • Interventional cardiology
  • Cardiac imaging

Background:

  • Severe secondary mitral regurgitation (SMR) necessitates advanced treatment options.
  • Transcatheter edge-to-edge repair (TEER) is a minimally invasive option for SMR.
  • Patient history includes hypertension and paroxysmal atrial fibrillation.

Observation:

  • Two-dimensional biplane imaging revealed an unusual anatomical finding.
  • A transverse basal left ventricle false tendon was observed.
  • The false tendon was noted to be attached to the papillary muscles.

Findings:

  • The identified false tendon's position raised concerns for potential interference.
  • Interference was specifically concerning during the planned mitral clip deployment.
  • This finding highlights the importance of detailed pre-procedural imaging.

Implications:

  • Accurate anatomical assessment is crucial for successful TEER procedures.
  • Uncommon cardiac structures may pose unique challenges in interventional cardiology.
  • Pre-procedural imaging can identify potential complications, optimizing patient outcomes.