Ayoub Chadi, Ranasinghe Isuru, Yiannikas John
Department of Cardiology, The University of Sydney, Level 3 West, Concord Repatriation General Hospital. Hospital Road, Sydney, NSW 2139, Australia.
J Clin Ultrasound. 2014 May;42(4):245-8. doi: 10.1002/jcu.22094. Epub 2013 Sep 20.
Elongated anterior mitral valve leaflet (EAMVL) has not been reported to cause left ventricular outflow tract obstruction (LVOTO) in the absence of left ventricular hypertrophy. We report the case of an elderly male patient who presented with acute heart failure and severe mitral regurgitation in the setting of dehydration. Echocardiography revealed acute LVOTO secondary to EAMVL. The patient was ineligible for surgery and was treated with negative inotropic agents, which ensured resolution of heart failure and marked improvement in the degree of LVOTO. This case demonstrates that, under certain circumstances, EAMVL without associated left ventricular hypertrophy may produce hemodynamic compromise that can be successfully treated medically.
在无左心室肥厚的情况下，二尖瓣前叶冗长（EAMVL）尚未被报道可导致左心室流出道梗阻（LVOTO）。我们报告一例老年男性患者，其在脱水情况下出现急性心力衰竭和严重二尖瓣反流。超声心动图显示EAMVL继发急性LVOTO。该患者不适合手术，接受了负性肌力药物治疗，这确保了心力衰竭的缓解以及LVOTO程度的显著改善。该病例表明，在某些情况下，无相关左心室肥厚的EAMVL可能产生血流动力学损害，而这种损害可通过药物治疗成功处理。
