Hypertrophic cardiomyopathy

Case contributed by Tim Luijkx
Diagnosis almost certain

Presentation

Hypertrophic cardiomyopathy? Outflow obstruction? SAM?

Patient Data

Age: 35
Gender: Male
mri

Diameters:
LV 46 mm, RV 45 mm, interventricular septum 29 mm.

Functional parameters:
LV: EDV 211 ml, ESV 89 ml, SV 122 ml, EF 58%, CO 9.9 l/min, myocardial mass 169 g
LV (BSA corrected): EDV 101 ml/m², ESV 43 ml/m², SV 59 ml/m²
RV: EDV 177 ml, ESV 63 ml, SV 114 ml, EF 64%, CO 9.2 l/min
RV (BSA corrected): EDV 85 ml/m², ESV 30 ml/m², SV 55 ml/m²

Signficant hypertrophy of the basal interventricular septum with late enhancement.
Eccentric mitral valve jet up to the roof of the left atrium. This jet develops is caused by systolic anterior motion of the anterior leaflet of the mitral valve.

Good contraction of both ventricles. No focal wall motion abnormalities.

Conclusion:
Hypertrophic obstructive cardiomyopathy with hypertrophy of the interventricular septum, turbulent flow in the LV outflow tract and mitral valve and systolic anterior motion (SAM) of the anterior mitral valve leaflet.

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