title: Left-ventricular outflow tract obstruction by mitral valve ring calcification and proximal septal hypertrophy in elderly patients. Presentation of 2 clinical cases.
abstract: The pathophysiology, clinical presentation and prognosis of left-ventricular obstruction still represent an important cardiological problem. Various anatomical and/or functional mechanisms can cause this phenomenon. This report concerns 2 patients over 75 years old in whom the simultaneous presence of localized proximal septal hypertrophy and massive calcification in the anterior portion of the mitral valve ring provoked significant systolic intraventricular gradients. Cardiac rhythm disturbances and consequent variability of R-R intervals, found in both subjects, appear fundamental in determining the value of such gradients. Occasionally an anterior mitral ring calcification may bring about left-ventricular outflow tract obstruction in aged hearts where localized hypertrophy of the proximal portion of the intraventricular septum is present.
authors.affiliation: Cattedra di Cardiologia, Università di Parma, Italia.
authors.forename: R
authors.initials: R
authors.lastname: Bolognesi
authors.forename: D
authors.initials: D
authors.lastname: Tsialtas
authors.forename: G
authors.initials: G
authors.lastname: Tiberti
authors.forename: M
authors.initials: M
authors.lastname: Conti
authors.forename: C
authors.initials: C
authors.lastname: Manca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006332:Cardiomegaly / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011379:Prognosis; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology