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J Thorac Dis. 2015 Sep;7(9):E365-9. doi: 10.3978/j.issn.2072-1439.2015.09.22.

Dynamic obstruction induced by systolic anterior motion of the mitral valve in a volume-depleted left ventricle: an unexpected cause of acute heart failure in a patient with chronic obstructive pulmonary disease.

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1 Division of Cardiology, 2 Division of Pulmonology, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.


Systolic anterior motion (SAM) of the mitral valve (MV) and left ventricular outflow tract (LVOT) dynamic obstruction (DO) typically occur in hypertrophic cardiomyopathy; however, they can appear in an apparently normal heart in association with changes in cardiac loading conditions and/or hyperdynamic left ventricular (LV) performance. Meanwhile, chronic obstructive pulmonary disease (COPD) can impair LV filling by elevating pulmonary vascular resistance. The authors report a case of transient acute heart failure caused by LVOT DO resulting from SAM of the MV in a severely volume-depleted LV in a patient with acute COPD exacerbation.


Chronic obstructive pulmonary disease (COPD); dynamic obstruction (DO); echocardiography; mitral valve (MV); natriuretic peptide

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