Development of severe left ventricular outflow tract obstruction over the course of 14 years: an unusual natural history of hypertrophic obstructive cardiomyopathy.
A patient with hypertrophic obstructive cardiomyopathy who when first seen had a normal physial examination, chest x-ray, and electrocardiogram, and no provokable gradient with isoproterenol at cardiac catheterization, was re-evaluated after 14 years. At the time of re-evaluation, she was found to have a typical systolic ejection murmur, cardiomegaly, left ventricular hypertrophy, a pseudoinfarction pattern on electrocardiography, and a significant subaortic gradient both by catheterization and by doppler. This case demonstrates that hypertrophic obstructive cardiomyopathy can be a progressive disease and that patients with this condition warrant careful follow-up. Echocardiography with doppler may provide an excellent noninvasive method of following these patients.
D006332:Cardiomegaly / Q000209:etiology; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology; D013318:Stroke Volume; D013997:Time Factors