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Related Concept Videos

Cardiovascular System Abnormal Findings II: Auscultation01:25

Cardiovascular System Abnormal Findings II: Auscultation

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Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
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Left Ventricular Outflow Tract Lesion in a Patient With Rheumatic Valvular Disease: MacCallum Plaque?

Maria Gabriela Matta1, Ahmed Reza1, Bradley Hefford1

  • 1Department of Cardiology, Division of Specialist Medical Services, Gold Coast Hospital and Health Services, Southport, Australia.

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Summary

A transesophageal echocardiogram revealed an unusual mass in the left ventricular outflow tract (LVOT) of a patient with rheumatic heart disease. The mass was likely caused by mechanical trauma from aortic regurgitation.

Keywords:
LVOTMacCallum plaqueaortic regurgitationrheumatic heart disease

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Area of Science:

  • Cardiovascular Medicine
  • Diagnostic Imaging
  • Pathology

Background:

  • Chronic rheumatic valvulopathy can lead to complex cardiac complications.
  • Aortic regurgitation is a significant hemodynamic disturbance.
  • Left ventricular outflow tract (LVOT) masses require accurate diagnosis.

Observation:

  • Transesophageal echocardiography (TEE) visualized a mobile mass within the LVOT.
  • The mass measured 1.2 cm and exhibited erratic motion during cardiac cycles.
  • Echocardiographic views were obtained in both diastole and systole.

Findings:

  • The LVOT mass is strongly suspected to be a result of mechanical trauma.
  • Aortic regurgitation jet impact is the proposed mechanism of injury.
  • The patient had a history of chronic rheumatic valvulopathy.

Implications:

  • This case highlights a rare complication of rheumatic heart disease and aortic regurgitation.
  • Accurate echocardiographic assessment is crucial for identifying the etiology of LVOT masses.
  • Understanding the mechanism of mass formation can guide clinical management strategies.