title: Discrete subaortic stenosis in an adult Nigerian: a case report.
abstract: BACKGROUND
  Cases of discrete subaortic stenosis are rare in adults. To our knowledge, no case has been reported in Nigerian literature. Cases are thus likely to be missed or wrongly managed.
  
  
  OBJECTIVE
  To present a case of discrete membranous subaortic stenosis in an adult Nigerian with a view to creating awareness of the existence of this entity in our milieu.
  
  
  METHODS
  The patient a 46-year-old Nigerian presented with symptoms of angina pectoris and near syncope. Transthoracic 2-Dimensional / M-mode echocardiography demonstrated thickened and calcific aortic valves and laboratory investigations showed that he also had artherogenic dyslipidaemia. He was initially managed as a case of severe valvular aortic stenosis of rheumatic origin with associated dyslipidaemia and was referred for further evaluation and management abroad.
  
  
  RESULTS
  On further assessment at the referral centre, the diagnosis was reviewed to subaortic stenosis with severe left ventricular outflow tract obstruction (LVOTO) arising from a fibro muscular subaortic membrane after a repeat 2-D/M-mode and Doppler echocardiography. Coronary angiography showed normal coronaries. He had excision of the membrane with marked reduction in gradient across the left ventricular outflow tract. He has remained symptom free and stable thereafter.
  
  
  CONCLUSIONS
  Discrete membranous subaortic stenosis though rare in adults should be suspected in patients with clinical features of valvular aortic stenosis. Doppler echocardiography is thus mandatory in the evaluation of these patients.
authors: Cardiology Unit, Department of Medicine University of Calabar Teaching Hospital,Calabar,Nigeria.
authors: V O
authors: VO
authors: Ansa
authors: A U
authors: AU
authors: Etiuma
authors: I
authors: I
authors: Odudu-Umoh
authors: G
authors: G
authors: Eboh
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003937:Diagnosis, Differential; D021922:Discrete Subaortic Stenosis / Q000175:diagnosis* / Q000601:surgery; D015150:Echocardiography, Doppler; D006801:Humans; D008297:Male; D008875:Middle Aged