Hypertrophic cardiomyopathy with intermittent free mitral regurgitation-a surgical dilemma.
We describe the case of a 52-year-old woman presenting with non-ST elevation myocardial infarction, atrial fibrillation, and a new diagnosis of hypertrophic cardiomyopathy. Transesophageal echocardiography following hemodynamic deterioration revealed completely restricted mitral leaflet motion with free mitral regurgitation, and severe left ventricular outflow tract (LVOT) obstruction. Surgical intervention was considered; however, repeat imaging following a period of clinical stability revealed resolution of the findings suggesting a transient ischemic etiology. The case is supported by clinical and echocardiographic images with movie clips, and a discussion of the likely pathology in the context of the underlying condition.
Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
Patrick H
PH
Gibson
Sayra A
SA
Khandekar
Dylan
D
Taylor
Harald
H
Becher
D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003657:Decision Making; D004452:Echocardiography / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008991:Monitoring, Physiologic; D011379:Prognosis; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery
hypertrophic cardiomyopathy; ischemic mitral valve incompetence; mitral regurgitation