title: An unusual cause of left ventricular outflow tract obstruction: the importance of a new systolic murmur with a large pleural effusion.
abstract: BACKGROUND
  Left ventricular outflow tract obstruction due to systolic anterior motion of the mitral valve occurs as a result of a dynamic interplay between the anatomy and mechanics of the heart. While systolic anterior motion and left ventricular outflow tract obstruction are well-recognized hallmarks of hypertrophic obstructive cardiomyopathy, several other specific etiologies have been described with similar pathophysiology.
  
  
  METHODS
  We present a unique case of a middle-aged woman who developed acute dynamic left ventricular outflow tract obstruction due to systolic anterior motion of the mitral valve resulting from a large left-sided pleural effusion.
  
  
  CONCLUSIONS
  Dynamic outflow tract obstruction should be considered among the potential causes of a new systolic murmur in patients with large pleural effusions in the absence of valvular heart disease.
authors.affiliation: Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL33331, USA.
authors.forename: Bose
authors.initials: B
authors.lastname: Afolabi
authors.forename: Gian M
authors.initials: GM
authors.lastname: Novaro
authors.forename: Craig R
authors.initials: CR
authors.lastname: Asher
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D010996:Pleural Effusion / Q000150:complications* / Q000000981:diagnostic imaging; D054160:Systolic Murmurs / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014694:Ventricular Outflow Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology*