伴有动态左心室流出道梗阻的主动脉瓣狭窄：诊断与管理挑战——病例系列
Aortic Stenosis With Dynamic Left Ventricular Outflow Obstruction: Diagnostic and Management Challenges-A Case Series.
作者信息
Qian Frank, McGregor Pei-Chun, Latifi Ahmad Nawid, Aragam Jayashri
机构信息
Section of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
Heartbeat Health, New York, New York.
出版信息
CASE (Phila). 2024 Dec 20;9(1):9-18. doi: 10.1016/j.case.2024.10.002. eCollection 2025 Jan.
Abstract
• Serial stenoses with AS and HCM can pose diagnostic challenges with echocardiography. • Doppler assessment of AS in this situation can overestimate gradients and severity. • Consider TEE and invasive hemodynamics when diagnostic uncertainty remains.
摘要
• 伴有主动脉瓣狭窄（AS）和肥厚型心肌病（HCM）的串联狭窄会给超声心动图诊断带来挑战。
• 在这种情况下，对AS进行多普勒评估可能会高估压力阶差和严重程度。
• 当仍存在诊断不确定性时，考虑经食管超声心动图（TEE）和有创血流动力学检查。
相似文献
1
Aortic Stenosis With Dynamic Left Ventricular Outflow Obstruction: Diagnostic and Management Challenges-A Case Series.
CASE (Phila). 2024 Dec 20;9(1):9-18. doi: 10.1016/j.case.2024.10.002. eCollection 2025 Jan.
2
High left ventricular outflow tract gradient: Aortic stenosis, obstructive hypertrophic cardiomyopathy or both?
Rev Port Cardiol. 2015 May;34(5):357.e1-5. doi: 10.1016/j.repc.2014.10.007. Epub 2015 Apr 29.
3
Undiagnosed hypertrophic obstructive cardiomyopathy during transcatheter aortic valve replacement: a case report.
J Med Case Rep. 2018 Dec 18;12(1):372. doi: 10.1186/s13256-018-1904-8.
4
Fixed left ventricular outflow tract obstruction mimicking hypertrophic obstructive cardiomyopathy: pitfalls in diagnosis.
Echocardiography. 2016 Nov;33(11):1753-1761. doi: 10.1111/echo.13356. Epub 2016 Sep 10.
5
Left ventricular ejection hemodynamics before and after relief of outflow tract obstruction in patients with hypertrophic obstructive cardiomyopathy and valvular aortic stenosis.
J Thorac Cardiovasc Surg. 2020 Mar;159(3):844-852.e1. doi: 10.1016/j.jtcvs.2019.03.071. Epub 2019 Apr 4.
6
[Mitral valve dysplasia in a cat causing reversible left ventricular hypertrophy and dynamic outflow tract obstruction].
Tijdschr Diergeneeskd. 2011 May 1;136(5):326-31.
7
A case report and analysis of hypertrophic obstructive cardiomyopathy causing an illusion of aortic stenosis.
Medicine (Baltimore). 2018 Dec;97(50):e13711. doi: 10.1097/MD.0000000000013711.
8
Significance of left ventricular outflow tract cross-sectional area in hypertrophic cardiomyopathy: a two-dimensional echocardiographic assessment.
Circulation. 1983 May;67(5):1100-8. doi: 10.1161/01.cir.67.5.1100.
9
Outcomes in Patients With Obstructive Hypertrophic Cardiomyopathy and Concomitant Aortic Stenosis Undergoing Surgical Myectomy and Aortic Valve Replacement.
J Am Heart Assoc. 2021 Sep 21;10(18):e018435. doi: 10.1161/JAHA.120.018435. Epub 2021 Sep 17.
10
Predictors of long-term outcomes in symptomatic hypertrophic obstructive cardiomyopathy patients undergoing surgical relief of left ventricular outflow tract obstruction.
Circulation. 2013 Jul 16;128(3):209-16. doi: 10.1161/CIRCULATIONAHA.112.000849. Epub 2013 Jun 14.
引用本文的文献
1
Outcomes of Surgical Myectomy and Mitral Valve Repair for Hypertrophic Cardiomyopathy With vs Without Marked Septal Hypertrophy.
CJC Open. 2025 Apr 19;7(7):851-859. doi: 10.1016/j.cjco.2025.04.007. eCollection 2025 Jul.
本文引用的文献
1
Aortic Stenosis Associated with Hypertrophic Cardiomyopathy: A Double Trouble.
Cardiology. 2023;148(3):287-288. doi: 10.1159/000530663. Epub 2023 Apr 14.
2
Recommendations for Multimodality Cardiovascular Imaging of Patients with Hypertrophic Cardiomyopathy: An Update from the American Society of Echocardiography, in Collaboration with the American Society of Nuclear Cardiology, the Society for Cardiovascular Magnetic Resonance, and the Society of Cardiovascular Computed Tomography.
J Am Soc Echocardiogr. 2022 Jun;35(6):533-569. doi: 10.1016/j.echo.2022.03.012.
3
Diagnosis and Evaluation of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review.
J Am Coll Cardiol. 2022 Feb 1;79(4):372-389. doi: 10.1016/j.jacc.2021.12.002.
4
Outcomes in Patients With Obstructive Hypertrophic Cardiomyopathy and Concomitant Aortic Stenosis Undergoing Surgical Myectomy and Aortic Valve Replacement.
J Am Heart Assoc. 2021 Sep 21;10(18):e018435. doi: 10.1161/JAHA.120.018435. Epub 2021 Sep 17.
5
2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Circulation. 2020 Dec 22;142(25):e558-e631. doi: 10.1161/CIR.0000000000000937. Epub 2020 Nov 20.
6
Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis.
JACC Cardiovasc Imaging. 2019 Sep;12(9):1835-1848. doi: 10.1016/j.jcmg.2019.01.045.
7
A case of hypertrophic obstructive cardiomyopathy with aortic stenosis.
J Cardiol Cases. 2014 Jan 15;9(4):129-133. doi: 10.1016/j.jccase.2013.12.003. eCollection 2014 Apr.
8
Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography.
J Am Soc Echocardiogr. 2019 Jan;32(1):1-64. doi: 10.1016/j.echo.2018.06.004. Epub 2018 Oct 1.
9
Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.
J Am Soc Echocardiogr. 2017 Apr;30(4):372-392. doi: 10.1016/j.echo.2017.02.009.
10
Fool me once, fool me twice: hypertrophic cardiomyopathy with aortic stenosis.
Am J Med. 2015 Oct;128(10):1076-9. doi: 10.1016/j.amjmed.2015.05.003. Epub 2015 Jul 1.
Zotero 插件