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All of the research institutions agree on at least two main criteria needed to accurately diagnose TTS: 1) transient left ventricular wall motion abnormality and 2) the absence of a condition obviously explaining this wall motion abnormality (coronary artery lesion, hypoperfusion, myocarditis, toxicity, etc.).
Left ventricular hypertrophy with secondary repolarization abnormalities as seen on ECG Histopathology of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm. Gross pathology of left ventricular hypertrophy. Left ventricle is at right in image, serially sectioned from apex to near base.
In normal subjects, the left ventricular ejection fraction (LVEF) should be about 50% [9] (range, 50-80%). There should be no area of abnormal wall motion (hypokinesis, akinesis or dyskinesis). Abnormalities in cardiac function may be manifested as a decrease in LVEF and/or the presence of abnormalities in global and regional wall motion.
The diagnosis of left ventricular outflow tract obstruction is usually made by echocardiographic assessment and is defined as a peak left ventricular outflow tract gradient of ≥ 30 mmHg. [35] Another, non-obstructive variant of HCM is apical hypertrophic cardiomyopathy (AHCM or ApHCM), [37] also called Yamaguchi syndrome.
Myocardial perfusion imaging or scanning (also referred to as MPI or MPS) is a nuclear medicine procedure that illustrates the function of the heart muscle (). [1]It evaluates many heart conditions, such as coronary artery disease (CAD), [2] hypertrophic cardiomyopathy and heart wall motion abnormalities.
Though it is the case that eccentric hypertrophy is largely considered to be a healthy response to increased cardiac demand, it is also associated with risks. For example, in athletes with significantly increased left ventricular weight there is also a corresponding increased risk for conduction abnormalities and sudden cardiac death.
Finally, images of the heart are taken "at stress" to assess wall motion at the peak heart rate. A stress echo assesses wall motion of the heart; it does not, however, create an image of the coronary arteries directly. Ischemia of one or more coronary arteries could cause a wall motion abnormality, which could indicate coronary artery disease.
A ventricular outflow tract obstruction is a heart condition in which either the right or left ventricular outflow tract is blocked or obstructed. These obstructions represent a spectrum of disorders. Majority of these cases are congenital, but some are acquired throughout life. [1]