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Int J Cardiol. 2009 Feb 20;132(2):270-2. Epub 2007 Nov 28.

Latent left ventricular outflow tract obstruction induced by abnormal hypertrophic papillary muscle caused myocardial ischemia.

Abstract

Left ventricular outflow tract (LVOT) obstruction is a typical recognized feature in hypertrophic cardiomyopathy. However, it has been shown in other clinical scenarios such as acute ischemia. In some patients, LVOT obstruction may only be detectable with provocation testing such as exercise stress. Accurate and timely diagnosis, therefore, relies on recognizing an echocardiographic substrate in which LVOT obstruction may occur, such as ventricular hypertrophy. This report describes the case of a patient presenting with effort ECG and signs of myocardial ischemia, with no significant narrowing of coronary arteries but with latent LVOT obstruction due to the presence of an abnormal hypertrophic papillary muscle instead of a typical ventricle hypertrophy.

PMID:
18045713
DOI:
10.1016/j.ijcard.2007.08.036
[Indexed for MEDLINE]

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