Increased mitral regurgitation during the valsalva maneuver in a patient with pheochromocytoma, uncontrolled hypertension, cardiac hypertrophy, and dynamic outflow tract obstruction

Dynamic left ventricular outflow tract obstruction is a common feature of hypertrophic cardiomyopathy, but it can also be demonstrated in other conditions that result in increased thickness of the left ventricular septal wall. Severe uncontrolled hypertension may lead to severe hypertrophy of the left ventricle and produce systolic anterior motion of the mitral valve and an outflow gradient. We report a case of pheochromocytoma with echocardiographic demonstration of markedly increased mitral regurgitation during the Valsalva maneuver in a patient with left ventricular hypertrophy and a dynamic outflow tract obstruction.