title: Paradoxical systolic and diastolic flow abnormalities in hypertrophic cardiomyopathy with mid-cavity systolic obstruction.
abstract: Systolic obstruction of the left ventricular outflow tract, either at rest or during provocation, is a frequent finding in patients with hypertrophic cardiomyopathy. Mid-cavity obstruction is uncommon, and intraventricular diastolic pressure gradients in association with either mid-cavity of apical hypertrophy are reported only rarely. We describe a patient with hypertrophic cardiomyopathy with evidence of systolic mid-cavity obstruction, and with complex diastolic paradoxical flow abnormalities within the left ventricular cavity detected by colour and pulsed-wave Doppler. Contrast echocardiography confirmed the presence of diastolic and systolic obstruction at the mid-ventricular level, with evidence of an apical cavity sequestered from the main body of the left ventricle during systolic mid-cavity obliteration.
authors.affiliation: Manchester Heart Center, Manchester Royal Infirmary, UK. mluckie@doctors.net.uk
authors.forename: Matthew
authors.initials: M
authors.lastname: Luckie
authors.forename: Rajdeep
authors.initials: R
authors.lastname: Khattar
mesh_terms: D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D013599:Systole / Q000502:physiology*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology*