Sub-aortic stenosis

Case contributed by Dr Allam Harfoush

Presentation

Exertional dyspnea, atypical chest pain and fatigue, especially during times of increased activity

Patient Data

Age: 40 years
Gender: Male
ultrasound

Left ventricle: LVIDd=54mm, normal systolic function.

Aortic Valve: normal tri-leaflet aortic valve, non-calcified leaflets, sufficient opening, observation of a sub-aortic membrane, Vmax=2.9, PGmean=21mmhg, PGmax=35mmhg.

Moderate aortic regurgitation.

Case Discussion

This patient presented with exertional dyspnea, atypical chest pain and fatigue especially during times of increased activity.

Examination showed a palpable systolic thrill at the apex.

Auscultation revealed a systolic murmur along the left sternal border and S2 was audible.

Sub-aortic stenosis is one of the types of left ventricular outflow tract obstruction presented with a membrane just below the aortic valve which causes a fixed obstruction to the blood flow across the left ventricular outflow tract.

In our case, the sub-aortic stenosis was corrected with mini-sternotomy surgery and the patient was discharged without complications.

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