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A ventricular outflow tract obstruction means there is a limitation in the blood flow out of either the right or left ventricles of the heart, depending on where the obstruction is. This can lead to cardiac hypertrophy, dilatation of the heart, and ultimately heart failure in some cases. [1]
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. [37] Another, non-obstructive variant of HCM is apical hypertrophic cardiomyopathy (AHCM or ApHCM), [39] also called Yamaguchi syndrome.
The right outflow tract is called "conus arteriosus" from the outside, and infundibulum from the inside. In the left ventricle the outflow tract is the "aortic vestibule". They both possess smooth walls, and are derived from the embryonic bulbus cordis [3] In both left and right ventricle there are specific structures separating the inflow and ...
For example, the Valsalva maneuver (phase II) increases the intensity of hypertrophic cardiomyopathy murmurs, namely those of dynamic subvalvular left ventricular outflow obstruction. This is due to the decreased preload in this phase, worsening the obstruction and thus accentuating the murmur. [3]
Mid-ventricular and left ventricular outflow obstruction: It has been suggested that a mid-ventricular wall thickening with outflow obstruction is important in the pathophysiology. [33] A quarter of unselected patients with TTS who presented to an emergency department were found to have obstructive hypertrophic cardiomyopathy (HCM) on blinded ...
The former means the ventricle is doing "volume" work, and the latter with "pressure" work (high pressure within left ventricle; some may transmit to the aorta, some may not). The latter can be seen in cases with left ventricle hypertrophy or outflow obstruction.
Outflow tract obstruction leads to left ventricular hypertrophy and reduction in the left ventricular lumen. One example of this would be in the case of aortic stenosis. Aortic stenosis that occurs during fetal development results in added stress on the left ventricle in utero. This can eventually lead to decreased perfusion through the left ...
A forceful apex beat indicates left ventricular pressure overload, while a right ventricular heave suggests right ventricular pressure overload. Other signs provide evidence for specific causes of pressure overload. Hypertension is diagnosed by sphygmomanometry.
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