What is dynamic outflow obstruction?

Dynamic LV Outflow Tract Obstruction Definition. Obstruction to the LVOT by structural abnormalities. which can be provoked or altered by a change in the. physiological conditions. Sherif M Helmy, MD, FASE, ICU, Qatar 2019.

What is LV outflow tract obstruction?

Left ventricular outflow tract obstruction (LVOTO) is a recognised feature of hypertrophic cardiomyopathy. It is caused by the thickened heart muscle and the abnormal movement of the mitral valve. This is the main mechanism of debilitating symptoms in hypertrophic cardiomyopathy patients.

What is a dynamic left ventricle?

The most common cause of dynamic obstruction/tightening of the left ventricular outflow tract is so-called SAM (systolic anterior motion), i.e. a “forward” mitral valve systolic motion towards the LVOT (left ventricular outflow tract)(3).

How is Lvot treated?

The pharmacological treatment of LVOT obstruction and related symptoms in HCM patients is based on a time-honoured combination of negative inotropic agents, including β-blockers, calcium antagonists, and disopyramide.

Which is hallmark of dynamic LV outflow tract obstruction?

Hallmarks of Dynamic LV Outflow Tract Obstruction •Obstruction occurs in mid to late systole > Dagger shaped Doppler signal •Associated with SAM •Posteriorly directed MR jet •Mid systolic closure of the aortic cusps •Provoked by or altered by loading conditions Sherif M Helmy, MD, FASE, ICU, Qatar 2019

How does left ventricular outflow tract obstruction affect heart failure?

In patients with hypertrophic cardiomyopathy, left ventricular outflow tract obstruction at rest is a strong, independent predictor of progression to severe symptoms of heart failure and of death.

What causes outflow tract obstruction in hypertrophic?

The constellation of a dynamic murmur, systolic anterior motion of the mitral valve with an open ventricular chamber and a late-peaking Doppler echocardiographic signal needs to be demonstrated either under resting conditions or with physiological provocation.

How is dynamic LVOT obstruction associated with HCM?

•Dynamic LVOT obstruction has been associated with HCM. •Recently it was noted that it also occurs in numerous diseases and may be found absence of a noticeable cardiac disease (<1% cases). •It is usually transient and accompany certain clinical situations.