title: Successful negative inotropic treatment of acute left ventricular outflow tract obstruction by elongated mitral valve leaflet.
abstract: Elongated anterior mitral valve leaflet (EAMVL) has not been reported to cause left ventricular outflow tract obstruction (LVOTO) in the absence of left ventricular hypertrophy. We report the case of an elderly male patient who presented with acute heart failure and severe mitral regurgitation in the setting of dehydration. Echocardiography revealed acute LVOTO secondary to EAMVL. The patient was ineligible for surgery and was treated with negative inotropic agents, which ensured resolution of heart failure and marked improvement in the degree of LVOTO. This case demonstrates that, under certain circumstances, EAMVL without associated left ventricular hypertrophy may produce hemodynamic compromise that can be successfully treated medically.
authors.affiliation: Department of Cardiology, The University of Sydney, Level 3 West, Concord Repatriation General Hospital. Hospital Road, Sydney, NSW 2139, Australia.
authors.forename: Chadi
authors.initials: C
authors.lastname: Ayoub
authors.forename: Isuru
authors.initials: I
authors.lastname: Ranasinghe
authors.forename: John
authors.initials: J
authors.lastname: Yiannikas
mesh_terms: D000208:Acute Disease; D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D016896:Treatment Outcome; D014463:Ultrasonography; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*
chemical_list: D002316:Cardiotonic Agents
keywords: disopyramide; mitral; systolic anterior motion; valve; β-blockers