Paradoxical systolic and diastolic flow abnormalities in hypertrophic cardiomyopathy with mid-cavity systolic obstruction

Matthew Luckie; Rajdeep Khattar

Vol 18, No 3 (2011)

Case Reports

Submitted: 2013-01-14

Published online: 2011-06-09

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Paradoxical systolic and diastolic flow abnormalities in hypertrophic cardiomyopathy with mid-cavity systolic obstruction

Matthew Luckie, Rajdeep Khattar

Cardiol J 2011;18(3):314-317.

Vol 18, No 3 (2011)

Case Reports

Submitted: 2013-01-14

Published online: 2011-06-09

Abstract

Systolic obstruction of the left ventricular outflow tract, either at rest or during provocation, is a frequent finding in patients with hypertrophic cardiomyopathy. Mid-cavity obstruction is uncommon, and intraventricular diastolic pressure gradients in association with either mid-cavity of apical hypertrophy are reported only rarely. We describe a patient with hypertrophic cardiomyopathy with evidence of systolic mid-cavity obstruction, and with complex diastolic paradoxical flow abnormalities within the left ventricular cavity detected by colour and pulsed-wave Doppler. Contrast echocardiography confirmed the presence of diastolic and systolic obstruction at the mid-ventricular level, with evidence of an apical cavity sequestered from the main body of the left ventricle during systolic mid-cavity obliteration. (Cardiol J 2011; 18, 3: 314–317)