Transient dynamic left ventricular outflow tract obstruction

Abstract

Dynamic left ventricular outflow (LVOT) obstruction has been classically described in patients with hypertrophic cardiomyopathy (HCM). The hypertrophy of the basal septum and systolic anterior motion of the mitral valve leaflet (SAM) cause dynamic LVOT obstruction. In addition, HCM also shows speckled appearance of myocardium and LVOT obstruction is persistent, although to a varying degree. Several other conditions cause the echocardiographic finding of dynamic LVOT obstruction like postoperative patients with hypovolemia, post aortic valve replacement (AVR) or mitral valve repair, hyperdynamic left ventricle and acute anteroapical myocardial infarction. We report two patients who had transient dynamic left ventricular outflow obstruction one with hypertension, mitral valve prolapse associated with hypovolemia and anaemia and another with vomiting and hypovolemia.

Keywords

• dynamic obstruction
• hypertrophic cardiomyopathy
• transient obstruction