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Flail Subaortic Membrane Mimicking Left Ventricular Outflow Tract Obstruction in Hypertrophic Cardiomyopathy Initially Detected by Transesophageal Echocardiography

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초록

A subaortic membrane is an uncommon cause for left ventricular outflow tract obstruction. Hypertrophic cardiomyopathy with dynamic left ventricular outflow tract obstruction would mask the presence of the subaortic membrane on transthoracic echocardiography and cause a false diagnosis. We report a patient with subaortic stenosis due to flail subaortic membrane misdiagnosed as obstructive hypertrophic cardiomyopathy on transthoracic echocardiography, identified on transesophageal echocardiography and cardiac catheterization.

Abstract

A subaortic membrane is an uncommon cause for left ventricular outflow tract obstruction. Hypertrophic cardiomyopathy with dynamic left ventricular outflow tract obstruction would mask the presence of the subaortic membrane on transthoracic echocardiography and cause a false diagnosis. We report a patient with subaortic stenosis due to flail subaortic membrane misdiagnosed as obstructive hypertrophic cardiomyopathy on transthoracic echocardiography, identified on transesophageal echocardiography and cardiac catheterization.

참고문헌 (8)

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  2. Choi JY, "Fixed subaortic stenosis: anatomical spectrum and nature of progression", Br Heart J, 65, pp.280~286 (1991)
  3. Teis A, "Subaortic membrane: correlation of imaging with pathology", Eur Heart J, 31, pp.2822~ (2010)
  4. Maron MS, "Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy", N Engl J Med, 348, pp.295~303 (2003)
  5. Bruce CJ, "Fixed left ventricular outflow tract obstruction in presumed hypertrophic obstructive cardiomyopathy: implications for therapy", Ann Thorac Surg, 68, pp.100~104 (1999)
  6. Oliver JM, "Discrete subaortic stenosis in adults: increased prevalence and slow rate of progression of the obstruction and aortic regurgitation", J Am Coll Cardiol, 38, pp.835~842 (2001)
  7. Onbasili AO, "Subaortic stenosis caused by flail discrete membrane in an older patient", Heart, 90, pp.399~ (2004)
  8. Nagueh SF, "American Society of Echocardiography; American Society of Nuclear Cardiology; Society for Cardiovascular Magnetic Resonance; Society of Cardiovascular Computed Tomography. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with hypertrophic cardiomyopathy: Endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Magnetic Resonance, and Society of Cardiovascular Computed Tomography", J Am Soc Echocardiogr, 24, pp.473~498 (2011)

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