Key result
Fixed structural lesions causing left ventricular outflow tract obstruction with secondary hypertrophy may mimic hypertrophic obstructive cardiomyopathy, requiring careful diagnostic correlation.
Case Report
Careful correlation of clinical examination, Doppler evaluation, and advanced imaging is necessary to differentiate fixed LVOT lesions from HOCM.
Misdiagnosis risks inappropriate therapy in LVOT obstruction; case series leaves open prospective validation of differentiation methods.
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.
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Ayoub et al. (2016) conducted a case report in Left ventricular hypertrophy and left ventricular outflow tract obstruction. Fixed left ventricular outflow tract obstruction vs. Hypertrophic obstructive cardiomyopathy was evaluated. Fixed structural lesions causing left ventricular outflow tract obstruction with secondary hypertrophy may mimic hypertrophic obstructive cardiomyopathy, requiring careful diagnostic correlation.
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