Fixed left ventricular outflow tract obstruction mimicking hypertrophic obstructive cardiomyopathy: pitfalls in diagnosis.
We present a case series that highlights the diagnostic challenges with left ventricular hypertrophy (LVH) and left ventricular outflow tract obstruction (LVOTO). Fixed structural lesions causing LVOTO with secondary LVH may mimic hypertrophic obstructive cardiomyopathy (HOCM). Management of these two entities is critically different. Misdiagnosis and failure to recognize fixed left ventricular outflow tract (LVOT) lesions may result in morbidity as a result of inappropriate therapy and delay of definitive surgical treatment. It is thus necessary to identify the correct type and level of obstruction in the LVOT by careful correlation of clinical examination, Doppler evaluation, and advanced imaging findings.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.|The University of Sydney, Sydney, NSW, Australia.
Chadi
C
Ayoub
The University of Sydney, Sydney, NSW, Australia.|Department of Cardiology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
David
D
Brieger
Department of Cardiology, Concord Repatriation General Hospital, Sydney, NSW, Australia.|Department of Cardiothoracic Surgery, Westmead Hospital, Sydney, NSW, Australia.
Richard
R
Chard
The University of Sydney, Sydney, NSW, Australia.|Department of Cardiology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
John
J
Yiannikas
D000293:Adolescent; D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D016277:Ventricular Function, Left / Q000502:physiology*; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology
aortic stenosis; hypertrophic cardiomyopathy; left ventricular outflow tract obstruction; subvalvular; supravalvular; surgery