Key result
Latent LVOT obstruction from SAM causes Type II MI and syncope in a non-HCM patient.
Why the study?
LVOT obstruction can occur outside of hypertrophic cardiomyopathy when an anatomically susceptible heart experiences physiological conditions provoking systolic anterior motion of the mitral valve.
Case Report (n=1)
Latent LVOT obstruction due to systolic anterior motion of the mitral valve can occur in non-HCM patients with susceptible anatomy, leading to Type II myocardial infarction.
Answers are grounded in this paper and cite their sources.
Latent LVOTO warrants consideration in unexplained syncope with hypotension; extends known SAM triggers but leaves open generalizability.
Left ventricular outflow tract obstruction is a well-recognized feature in hypertrophic cardiomyopathy but can occur in other clinical scenarios when anatomically susceptible heart is subjected to permissive physiological conditions that provoke systolic anterior motion of the mitral valve (SAM): ie, reduced preload, increased inotropic state, and decreased afterload. This report describes a case of hemodynamically significant latent LVOTO that was associated with hypotension, syncope, acute myocardial ischemic ECG changes, and an increase in cardiac enzymes. (Type II myocardial infarction) in a non HCM patient with excessive anterior mitral valve tissue.
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Constantinos Makrides (2019) conducted a case report in Type II myocardial infarction and latent LVOT obstruction (n=1). Latent LVOT obstruction due to Systolic Anterior Motion of mitral valve was evaluated on Type II myocardial infarction, hypotension, syncope, acute myocardial ischemic ECG changes, and increase in cardiac enzymes. Latent LVOT obstruction due to systolic anterior motion of the mitral valve in a non-HCM patient with excessive anterior mitral valve tissue resulted in Type II myocardial infarction and syncope.
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