Current Diagnosis and Treatment Cardiology, Fifth Edition by Michael H. Crawford

Author:Michael H. Crawford [Crawford, Michael H.]
Language: eng
Format: azw3
Publisher: McGraw-Hill Education
Published: 2017-03-22T04:00:00+00:00

Figure 23–8. Continuous wave Doppler evaluation of a patient with hypertrophic cardiomyopathy during Valsalva provocation. Two distinct flow patterns are seen: one of the outflow obstruction, which has a late peak (light arrow), and a superimposed Doppler profile signal of mitral regurgitation (white arrow), making assessment of peak outflow obstruction velocity challenging.

D. Myocardial Ischemia

The combination of significant LVH with or without outflow obstruction sets the stage for substantial increase in myocardial oxygen demand and can precipitate angina secondary to myocardial ischemia in HCM. Angina has been reported in approximately 30% of HCM patients, and ischemic perfusion defects on myocardial perfusion imaging can be present in a large majority of patients with HCM. Although epicardial coronary disease may cause angina/perfusion defects, a supply-demand mismatch in conjunction with abnormal microvasculature is likely the major contributor.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.