What question did this study set out to answer?

To assess whether selective peripheral vasodilatation induced by amyl nitrite influences the severity of left ventricular outflow tract obstruction in muscular subaortic stenosis.

November 23, 1963JAMAOpen Access

Muscular Subaortic Stenosis: Effect of Peripheral Vasodilatation

Q: What does this research mean for the field?

Peripheral vasodilatation induced by amyl nitrite increases the degree of obstruction and decreases the systolic cross-sectional area of the left ventricular outflow tract in muscular subaortic stenosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Why the study?

Does amyl nitrite-induced peripheral vasodilatation increase left ventricular outflow tract obstruction in muscular subaortic stenosis?

Population

1 patient with muscular subaortic stenosis

Comparison

Amyl nitrite inhalation vs Baseline (prior to administration)

Design

Case_report

Authors

EWE.Douglas WigleHeart Failure / Cardiomyopathy SLS. C. LenkeiUniversity of Toronto ACA. ChrysohouUniversity of Toronto

Discussion

Member takes

Implication

Amyl nitrite may exacerbate LVOT obstruction in muscular subaortic stenosis; single case leaves open prospective validation.

Key Points

To assess whether selective peripheral vasodilatation induced by amyl nitrite influences the severity of left ventricular outflow tract obstruction in muscular subaortic stenosis.
Administered amyl nitrite inhalations on two separate occasions to a single patient (N=1) diagnosed with muscular subaortic stenosis.
Measured the systolic pressure gradient across the left ventricular outflow tract and quantified changes in the outflow tract systolic cross-sectional area before and after administration.
Systolic pressure gradient across the left ventricular outflow tract increased markedly on both administrations before reflex tachycardia occurred.
Systolic cross-sectional area of the left ventricular outflow tract decreased from a baseline control value of 2.6 sq. cm. to 1.0 sq. cm. following the second inhalation.

Structured PICO

Does amyl nitrite-induced peripheral vasodilatation increase left ventricular outflow tract obstruction in muscular subaortic stenosis?

Population

1 patient with muscular subaortic stenosis

Intervention

Amyl nitrite inhalation (administered on two occasions)

Comparator

Baseline (prior to administration)

Outcome

Systolic pressure gradient across the left ventricular outflow tract and systolic cross-sectional area of the left ventricular outflow tractsurrogate

Peripheral vasodilatation via amyl nitrite exacerbates left ventricular outflow tract obstruction in muscular subaortic stenosis, demonstrating the dynamic nature of the obstruction.

Cite This Study

Wigle et al. (1963) studied this question.

synapsesocial.com/papers/6a1bd0c04ebd09f3dfa90fe2 https://doi.org/10.1001/jama.1963.03710080101081

Topics

Hypertrophic cardiomyopathy

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Muscular Subaortic Stenosis: Effect of Peripheral Vasodilatation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Muscular Subaortic Stenosis: Effect of Peripheral Vasodilatation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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