Anomalous insertion of the papillary muscle causing left ventricular outflow obstruction: visualization by real-time three-dimensional echocardiography.
Anomalous insertion of the papillary muscle (PM)/chordae tendineae is a rare but important cause of dynamic left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy or cardiac amyloidosis. These anomalies are often challenging to diagnose with 2-D Echo, yet accurate diagnosis is critical in determining whether to proceed with an extended septal myectomy instead of a standard septal myectomy for relief. We report two cases of anomalous insertion of the PM causing LVOT obstruction with diagnosis facilitated by real-time 3-D echocardiograms.
Yang
Hyun Suk
HS
Division of Cardiovascular Diseases, Mayo College of Medicine, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
Lee
Kwan S
KS
Chaliki
Hari P
HP
Tazelaar
Henry D
HD
Lusk
Joan L
JL
Chandrasekaran
Krishnaswamy
K
Tajik
A Jamil
AJ
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000150:complications*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging; D019560:Echocardiography, Three-Dimensional; D006801:Humans; D008297:Male; D010210:Papillary Muscles / Q000002:abnormalities*; D012680:Sensitivity and Specificity; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology