Intrinsic abnormalities of the mitral valve, such as leaflet elongation and papillary muscle displacement, can cause significant systolic anterior motion and LVOT obstruction even without left ventricular hypertrophy.
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May prompt mitral apparatus evaluation in unexplained LVOT obstruction without LVH; hypothesis-generating for non-HCM SAM mechanisms.
We report a 15-year-old patient who presented with exercise dyspnea and limitation of physical activity. Echocardiography revealed significant left ventricular outflow tract obstruction caused by systolic anterior motion (SAM) of the mitral valve. The wall thickness of the left ventricle was within normal limits. Elongation of the mitral leaflets and anterior displacement of the posteromedial papillary muscle were apparent in the echocardiographic examination. These two factors have been previously demonstrated to play a central role in the occurrence of SAM in patients with hypertrophic cardiomyopathy. The present case validates that such intrinsic abnormalities of the mitral valve can cause significant SAM even in the absence of left ventricular hypertrophy.
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İzgi et al. (2010) studied this question.
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