High left ventricular outflow tract gradient: Aortic stenosis, obstructive hypertrophic cardiomyopathy or both?
The authors report the case of a patient diagnosed with both hypertrophic cardiomyopathy and aortic stenosis. Due to clinical deterioration, additional investigation was performed, and a high left ventricular outflow tract gradient was identified. Correct identification of the condition causing the symptoms was challenging, and involved several imaging techniques, the contribution of transesophageal echocardiography being crucial. The final diagnosis of severe aortic stenosis led to successful valve replacement surgery. The presence of these two conditions in the same patient has been documented, although it is uncommon. This association poses particular diagnostic and therapeutic challenges, which are discussed in this paper.
Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra - Hospital Geral, Coimbra, Portugal. Electronic address: inesalm@gmail.com.
Inês
I
Almeida
Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra - Hospital Geral, Coimbra, Portugal.
Francisca
F
Caetano
Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra - Hospital Geral, Coimbra, Portugal.
Joana
J
Trigo
Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra - Hospital Geral, Coimbra, Portugal.
Paula
P
Mota
Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra - Hospital Geral, Coimbra, Portugal.
António Leitão
AL
Marques
D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications / Q000503:physiopathology*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016277:Ventricular Function, Left; D014694:Ventricular Outflow Obstruction / Q000209:etiology
Aortic valve stenosis; Cardiomiopatia hipertrófica; Doppler echocardiography; Echocardiography; Ecocardiografia; Ecocardiografia Doppler; Estenose aórtica; Hypertrophic cardiomyopathy; Left ventricular outflow tract obstruction; Obstrução do trato de saída do ventrículo esquerdo