A patient with aortic valve stenosis and severe obstruction of the left ventricular outflow tract: a diagnostic challenge

• Published in: Deutsche medizinische Wochenschrift (1946) Vol. 135; no. 20; p. 1016
• Main Authors: Nentwich, Karin, Flachskampf, F A
• Format: Journal Article
• Language: German
• Published: Germany 01.05.2010
• Subjects: Aged, 80 and over; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - diagnosis; Aortic Valve Stenosis - therapy; Cardiac Pacing, Artificial; Cardiomyopathy, Hypertrophic - complications; Cardiomyopathy, Hypertrophic - diagnosis; Cardiomyopathy, Hypertrophic - therapy; Diagnosis, Differential; Humans; Male; Ventricular Outflow Obstruction - complications; Ventricular Outflow Obstruction - diagnosis; Ventricular Outflow Obstruction - therapy
• ISSN: 1439-4413
• DOI: 10.1055/s-0030-1253691

A 83-year-old male patient was admitted with dyspnoe and paroxysmal atrial fibrillation. A severe aortic stenosis was diagnosed 9 months before. Echocardiography now revealed severe obstruction of the left ventricular outflow tract, as part of an obstructive cardiomyopathy, mild aortic valve stenosis and mark4d left atrial dilatation. After spontaneous conversion into sinus rhythm the patient remained asymptomatic and continuing conservative treatment was recommended. It may be difficult to diagnose the correct components of systolic obstruction when there is both obstructive cardiomyopathy and aortic valve stenosis and thus decide on the optimal management of such a case.