An unusual cause of left ventricular outflow tract obstruction: the importance of a new systolic murmur with a large pleural effusion
Bose Afolabi, Gian M Novaro, Craig R Asher
Med Sci Monit 2008; 14(7): CS64-66
Available online: 2008-07-01
Left ventricular outflow tract obstruction due to systolic anterior motion of the mitral valve occurs as a result of a dynamic interplay between the anatomy and mechanics of the heart. While systolic anterior motion and left ventricular outflow tract obstruction are well-recognized hallmarks of hypertrophic obstructive cardiomyopathy, several other specific etiologies have been described with similar pathophysiology.
Material and Method: We present a unique case of a middle-aged woman who developed acute dynamic left ventricular outflow tract obstruction due to systolic anterior motion of the mitral valve resulting from a large left-sided pleural effusion.
Conclusions: Dynamic outflow tract obstruction should be considered among the potential causes of a new systolic murmur in patients with large pleural effusions in the absence of valvular heart disease.
Keywords: Ventricular Outflow Obstruction - ultrasonography, Systolic Murmurs - ultrasonography, Pleural Effusion - ultrasonography