Concealed left ventricular hypertrophy and diastolic dysfunction in hypertrophic cardiomyopathy in the presence of acute left ventricular volume overload. A case report.
We report a patient in whom hypertrophic cardiomyopathy, with both left ventricular hypertrophy and diastolic dysfunction, was masked by acute severe aortic regurgitation and marked left ventricular dilation. Upon admission, 1) two-dimensional echocardiogram of the left ventricle revealed a dynamic and flail vegetation on the aortic right coronary cusp and marked left ventricular dilation, 2) a massive aortic regurgitant signal was recorded by color Doppler flow imaging, and 3) transmitral flow velocity by pulsed Doppler echocardiogram revealed a pseudonormalization. However, symmetric hypertrophy of the left ventricular wall, a decrease in early diastolic wave and a compensatory increase in atrial systolic wave of the transmitral flow velocity appeared after successful aortic valve replacement.
Oki
T
T
Second Department of Internal Medicine, Tokushima University School of Medicine, Japan.
Iuchi
A
A
Tabata
T
T
Yamada
H
H
Manabe
K
K
Fukuda
K
K
Abe
M
M
Fukuda
N
N
Ito
S
S
D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery; D002306:Cardiac Volume; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003971:Diastole; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D006350:Heart Valve Prosthesis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left; D017725:Ventricular Pressure