title: Dynamic obstruction induced by systolic anterior motion of the mitral valve in a volume-depleted left ventricle: an unexpected cause of acute heart failure in a patient with chronic obstructive pulmonary disease.
abstract: Systolic anterior motion (SAM) of the mitral valve (MV) and left ventricular outflow tract (LVOT) dynamic obstruction (DO) typically occur in hypertrophic cardiomyopathy; however, they can appear in an apparently normal heart in association with changes in cardiac loading conditions and/or hyperdynamic left ventricular (LV) performance. Meanwhile, chronic obstructive pulmonary disease (COPD) can impair LV filling by elevating pulmonary vascular resistance. The authors report a case of transient acute heart failure caused by LVOT DO resulting from SAM of the MV in a severely volume-depleted LV in a patient with acute COPD exacerbation.
authors.affiliation: 1 Division of Cardiology, 2 Division of Pulmonology, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: Suji
authors.initials: S
authors.lastname: Kim
authors.affiliation: 1 Division of Cardiology, 2 Division of Pulmonology, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: So Jeong
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: 1 Division of Cardiology, 2 Division of Pulmonology, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: Jina
authors.initials: J
authors.lastname: Kim
authors.affiliation: 1 Division of Cardiology, 2 Division of Pulmonology, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: Phillhoon
authors.initials: P
authors.lastname: Yoon
authors.affiliation: 1 Division of Cardiology, 2 Division of Pulmonology, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: Jeongwoong
authors.initials: J
authors.lastname: Park
authors.affiliation: 1 Division of Cardiology, 2 Division of Pulmonology, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: Jeonggeun
authors.initials: J
authors.lastname: Moon
keywords: Chronic obstructive pulmonary disease (COPD); dynamic obstruction (DO); echocardiography; mitral valve (MV); natriuretic peptide