Midsystolic closure of the aortic valve in primary pulmonary hypertension

Echocardiographic examination in a patient with primary pulmonary hypertension demonstrated midsystolic closure of the aortic valve, which has often been described in hypertrophic cardiomyopathy with or without obstruction, in discrete subaortic stenosis, and in ruptured aneurysm of the right coronary sinus of Valsalva. A possible mechanism for this finding in primary pulmonary hypertension and differential diagnosis from other diseases are discussed.