[Hypertrophic cardiomyopathy with midventricular and subvalvular obstruction in both heart ventricles].
Typical (subaortic) and atypical (midventricular or apical) obstructions of both ventricles in HOCM are rare events. This combination could be demonstrated in a 21-year-old female patient by heart catheterization and angiocardiography. Simultaneous registration via 2 catheters in each ventricle showed pressure gradients with two steps in both ventricles: RV apical/RV midventricular 70-100 mm Hg, RV midventricular/subvalvular 25 mm Hg; LV apical/LV midventricular 70 mm Hg, LV midventricular/LV subvalvular 30 mm Hg; no valvular pressure gradients. Morphology of the obstructions is demonstrated by angiography: severe bilateral septal hypertrophy with midventricular systolic obstruction, systolic obstruction of right ventricular infundibulum by hypertrophy of the crista supraventricularis, systolic apical separation in the right ventricle; stenosis of the left ventricular outflow tract by SAM, systolic apical separation in the left ventricle by hypertrophy of papillary muscles.
D000328:Adult; D000790:Angiocardiography; D001020:Aortic Stenosis, Subvalvular / Q000175:diagnosis*; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D002932:Cineangiography; D004562:Electrocardiography; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis; D013599:Systole
Hypertrophische Kardiomyopathie mit medioventrikulärer und subvalvulärer Obstruktion in beiden Herzkammern.