Hypertrophic cardiomyopathy with obstruction: Important diagnostic clue provided by the direction of the mitral regurgitation jet

Cheng Yeo Tiong Cheng Yeo, Fletcher A Jr. Miller, Jae Kuen Oh, Hartzell V Schaff, A. M. Weissler, J. B. Seward

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Abstract

We present an unusual case of hypertrophic cardiomyopathy complicated by mitral regurgitation resulting from chordal rupture with flail posterior mitral leaflet. The diagnosis was suggested by the presence of an anteriorly directed mitral regurgitation jet on transthoracic color flow imaging, in addition to the typical posterolateral-lateral jet caused by systolic anterior mitral motion. The flail posterior leaflet was confirmed by transesophageal echocardiography, and the patient underwent mitral valve repair in addition to myectomy. This combination of hypertrophic cardiomyopathy and flail mitral leaflet usually requires surgical intervention, and prompt diagnosis is important. The presence of an anteriorly directed mitral regurgitant jet should always raise suspicion of posterior mitral leaflet abnormality.

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalJournal of the American Society of Echocardiography
Volume11
Issue number1
DOIs
StatePublished - 1998

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Hypertrophic Cardiomyopathy
Mitral Valve Insufficiency
Transesophageal Echocardiography
Mitral Valve
Rupture
Color
Direction compound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Hypertrophic cardiomyopathy with obstruction: Important diagnostic clue provided by the direction of the mitral regurgitation jet",
abstract = "We present an unusual case of hypertrophic cardiomyopathy complicated by mitral regurgitation resulting from chordal rupture with flail posterior mitral leaflet. The diagnosis was suggested by the presence of an anteriorly directed mitral regurgitation jet on transthoracic color flow imaging, in addition to the typical posterolateral-lateral jet caused by systolic anterior mitral motion. The flail posterior leaflet was confirmed by transesophageal echocardiography, and the patient underwent mitral valve repair in addition to myectomy. This combination of hypertrophic cardiomyopathy and flail mitral leaflet usually requires surgical intervention, and prompt diagnosis is important. The presence of an anteriorly directed mitral regurgitant jet should always raise suspicion of posterior mitral leaflet abnormality.",
author = "{Tiong Cheng Yeo}, {Cheng Yeo} and Miller, {Fletcher A Jr.} and Oh, {Jae Kuen} and Schaff, {Hartzell V} and Weissler, {A. M.} and Seward, {J. B.}",
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T1 - Hypertrophic cardiomyopathy with obstruction

T2 - Important diagnostic clue provided by the direction of the mitral regurgitation jet

AU - Tiong Cheng Yeo, Cheng Yeo

AU - Miller, Fletcher A Jr.

AU - Oh, Jae Kuen

AU - Schaff, Hartzell V

AU - Weissler, A. M.

AU - Seward, J. B.

PY - 1998

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N2 - We present an unusual case of hypertrophic cardiomyopathy complicated by mitral regurgitation resulting from chordal rupture with flail posterior mitral leaflet. The diagnosis was suggested by the presence of an anteriorly directed mitral regurgitation jet on transthoracic color flow imaging, in addition to the typical posterolateral-lateral jet caused by systolic anterior mitral motion. The flail posterior leaflet was confirmed by transesophageal echocardiography, and the patient underwent mitral valve repair in addition to myectomy. This combination of hypertrophic cardiomyopathy and flail mitral leaflet usually requires surgical intervention, and prompt diagnosis is important. The presence of an anteriorly directed mitral regurgitant jet should always raise suspicion of posterior mitral leaflet abnormality.

AB - We present an unusual case of hypertrophic cardiomyopathy complicated by mitral regurgitation resulting from chordal rupture with flail posterior mitral leaflet. The diagnosis was suggested by the presence of an anteriorly directed mitral regurgitation jet on transthoracic color flow imaging, in addition to the typical posterolateral-lateral jet caused by systolic anterior mitral motion. The flail posterior leaflet was confirmed by transesophageal echocardiography, and the patient underwent mitral valve repair in addition to myectomy. This combination of hypertrophic cardiomyopathy and flail mitral leaflet usually requires surgical intervention, and prompt diagnosis is important. The presence of an anteriorly directed mitral regurgitant jet should always raise suspicion of posterior mitral leaflet abnormality.

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