Key result
Simultaneous catheterization in MVOHCM demonstrates a severe ~90 mmHg apex-to-base systolic gradient.
Why the study?
This report investigates the pathogenesis of left ventricular apical aneurysm and paradoxic jet flow in mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM).
Case Report (n=1)
No
Extreme apical pressures possible in MVOHCM warrant clinical awareness; leaves open prevalence and management implications pending cohort data.
A 70-year-old man was diagnosed with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) with apical aneurysm and paradoxic jet flow. At cardiac catheterization, pressure study showed that there was a markedly high pressure-gradient of 90 mmHg between the apex and the base in systole. Apical pressure was 350 mmHg after premature ventricular contraction. The apical aneurysm was already dilated and spherical in late systole; the absence of active relaxation was considered to be the cause of the paradoxic jet flow. In this report, we suggest the pathogenesis of left ventricular apical aneurysm and paradoxic jet flow in MVOHCM.
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Hanaoka et al. (2012) conducted a case report in Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) with apical aneurysm and paradoxic jet flow (n=1). Simultaneous left ventricular apical and basal pressure recording (followed by calcium channel blocker and beta-blocker medication) was evaluated on Systolic pressure gradient between the left ventricular apex and base. Simultaneous cardiac catheterization in a 70-year-old man with MVOHCM revealed a 90 mmHg systolic apex-to-base pressure gradient and an apical pressure reaching 350 mmHg post-PVC.
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