Mookadam Farouk, Haley John H, Olson Lyle J, Cikes Maja, Mookadam Martina
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, USA.
Eur J Echocardiogr. 2006 Dec;7(6):465-8. doi: 10.1016/j.euje.2005.09.002. Epub 2005 Oct 19.
Dynamic left ventricular outflow tract (LVOT) obstruction is classically seen in hypertrophic obstructive cardiomyopathy (HOCM). This can also be seen in cardiac amyloidosis. We describe a rare case of senile systemic amyloidosis with dynamic LVOT obstruction and concomitant three vessel coronary artery disease presenting with clinical and echocardiographic findings similar to those seen in HOCM. We also highlight the importance of distinguishing the sub-types of amyloidosis so that the appropriate therapy can be offered to patients with cardiac involvement, including coronary artery bypass grafting and septal myotomy/myectomy to relieve LVOT obstruction in the more benign forms of cardiac amyloidosis.
动态左心室流出道（LVOT）梗阻在肥厚型梗阻性心肌病（HOCM）中较为典型。在心脏淀粉样变性中也可出现。我们描述了一例罕见的老年系统性淀粉样变性病例，伴有动态LVOT梗阻和三支冠状动脉疾病，其临床和超声心动图表现与HOCM相似。我们还强调了区分淀粉样变性亚型的重要性，以便为有心脏受累的患者提供适当的治疗，包括冠状动脉旁路移植术和间隔肌切开术/心肌切除术，以缓解较良性心脏淀粉样变性形式中的LVOT梗阻。
