Exercise-Stress Echocardiography Reveals Systolic Anterior Motion of the Mitral Valve as a Cause of Syncopes in a Cardiac Amyloidosis PatientReportar como inadecuado




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Case Reports in Cardiology - Volume 2016 2016, Article ID 3198715, 4 pages -

Case Report

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

Department of Hematology, Aarhus University Hospital, Aarhus, Denmark

Department of Pathology, Aarhus University Hospital, Aarhus, Denmark

Received 12 July 2016; Accepted 18 October 2016

Academic Editor: Hiroaki Kitaoka

Copyright © 2016 Tor Skibsted Clemmensen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with cardiac amyloidosis are at increased AV-block and syncope risk. Therefore, a prophylactic pacemaker is often implanted. However, this case illustrates that other mechanisms should be ruled out prior to pacemaker implantation. The patient studied had mitral valve thickening without increased left ventricular outflow track LVOT velocity. However, bicycle exercise-stress test with simultaneous echocardiography revealed a stepwise decrease in blood pressure, a substantial increase in the LVOT velocity, and severe systolic anterior motion of the mitral valve. The patients’ symptoms were likely explained by these findings. Therefore, a comprehensive clinical evaluation is warranted prior to pacemaker implantation in cardiac amyloidosis patients.





Autor: Tor Skibsted Clemmensen, Henning Mølgaard, Niels Frost Andersen, Steen Baerentzen, and Steen Hvitfeldt Poulsen

Fuente: https://www.hindawi.com/



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