title: Dynamic LVOT Obstruction and Aortic Stenosis in the Same Patient: A Case of Challenging Doppler Hemodynamics.
abstract: We present a patient with both dynamic left ventricular outflow tract obstruction and valvular aortic stenosis. The aortic valve was calcified, and velocities and gradients measured by continuous-wave Doppler met standard criteria for severe aortic stenosis. The increased subvalvular velocities invalidated assumptions of the simplified Bernoulli equation; correction using the longer form of the Bernoulli equation suggested a lower but still significant gradient. The complex shape of the subvalvular spectral Doppler envelope indicated supranormal systolic function and dynamic left ventricular outflow obstruction. Left heart catheterization with an end-hole catheter was required to determine the subvalvular and valvular components of the obstruction.
authors: Hartford Hospital Division of Cardiology, Hartford, Connecticut.|University of Connecticut School of Medicine, Farmington, Connecticut.
authors: Matthew W
authors: http://orcid.org/0000-0002-3772-3742
authors: MW
authors: Parker
authors: Hartford Hospital Division of Cardiology, Hartford, Connecticut.|University of Connecticut School of Medicine, Farmington, Connecticut.
authors: Francis J
authors: FJ
authors: Kiernan
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D016477:Artifacts; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D014694:Ventricular Outflow Obstruction / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: Doppler hemodynamics; aortic stenosis; left ventricular outflow obstruction