| Title: |
Hypertrophic cardiomyopathy with anteriorly directed mitral regurgitation is a red flag for concomitant pathology: A case report |
| Authors: |
Somma, V; Raman, J; Fitzpatrick, L; Prior, D; Paratz, E |
| Contributors: |
Sepulveda, EFC; Jakstaite, AM; Cvijic, M; Abdullah, A |
| Publisher Information: |
OXFORD UNIV PRESS |
| Publication Year: |
2024 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is often linked to systolic anterior motion (SAM) of the mitral valve, typically resulting in a posteriorly directed mitral regurgitation (MR) jet. An anteriorly directed MR jet suggests additional mitral valve pathology that may not be resolved by myectomy alone. CASE SUMMARY: A 58-year-old construction worker with no significant medical history experienced a syncopal event and was admitted to the emergency department with acute pulmonary oedema. A systolic murmur was investigated with a trans-thoracic echocardiogram that revealed severe MR with an unusual anteriorly directed MR jet and a possible flail segment of the posterior leaflet. This finding was further characterized with a trans-oesophageal echocardiogram that revealed severe asymmetric septal hypertrophy with SAM of the mitral valve, severe mitral regurgitation into a dilated left atrium with pulmonary vein flow reversal not caused by HCM-associated SAM, and a markedly abnormal mitral valve with flail and prolapse. The patient underwent successful cardiac surgery, including mitral valve repair and septal myectomy. The patient's recovery was uneventful, allowing for a return to work within a month post-surgery. DISCUSSION: The anteriorly directed MR jet served as a red flag, leading to the discovery of an independent mitral valve pathology that required surgical intervention beyond the expected treatment for SAM-associated HCM. This case highlights the complexity of assessing MR in patients with HCM and underscores the importance of characterizing MR jet direction in diagnosing additional mitral valve diseases. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
2514-2119 |
| Relation: |
pii: ytae121; Somma, V., Raman, J., Fitzpatrick, L., Prior, D. & Paratz, E. (2024). Hypertrophic cardiomyopathy with anteriorly directed mitral regurgitation is a red flag for concomitant pathology: A case report. European Heart Journal Case Reports, 8 (3), https://doi.org/10.1093/ehjcr/ytae121.; https://hdl.handle.net/11343/353230 |
| Availability: |
https://hdl.handle.net/11343/353230 |
| Rights: |
https://creativecommons.org/licenses/by/4.0 ; CC BY |
| Accession Number: |
edsbas.57C073DF |
| Database: |
BASE |