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Nonobstructive septal hypertrophy in a young adult provoking recurrent polymorphic ventricular tachycardia successfully treated with transaortic and transventricular.

Published byMaría Concepción Venegas Modified over 5 years ago

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Presentation on theme: "Nonobstructive septal hypertrophy in a young adult provoking recurrent polymorphic ventricular tachycardia successfully treated with transaortic and transventricular."— Presentation transcript:

1 Nonobstructive septal hypertrophy in a young adult provoking recurrent polymorphic ventricular tachycardia successfully treated with transaortic and transventricular septal myectomy: A case report  Philip Y. Sun, MSc, John P. Bois, MD, Seth H. Sheldon, MD, Samuel J. Asirvatham, MD, FHRS  HeartRhythm Case Reports  Volume 1, Issue 5, Pages (September 2015) DOI: /j.hrcr Copyright © 2015 Heart Rhythm Society Terms and Conditions

2 Figure 1 A 12-lead resting electrocardiogram demonstrating increased voltage consistent with left ventricular hypertrophy and anterolateral ST depression and T-wave inversion consistent with hypertrophic cardiomyopathy. HeartRhythm Case Reports 2015 1, DOI: ( /j.hrcr ) Copyright © 2015 Heart Rhythm Society Terms and Conditions

3 Figure 2 A: Parasternal long-axis transthoracic echocardiogram demonstrating marked septal hypertrophy (29 mm) and reverse-curve morphology. B: Continuous wave Doppler echocardiogram through the left ventricular outflow tract in the apical long-axis view without evidence of obstruction (highest recorded gradient was 0.8 m/s). HeartRhythm Case Reports 2015 1, DOI: ( /j.hrcr ) Copyright © 2015 Heart Rhythm Society Terms and Conditions

4 Figure 3 Echocardiogram stress test results revealing pronounced ST depressions in the anterior, anterolateral, and inferior leads with ST elevation in AVR. These findings developed 1 minute 50 seconds into a Bruce-protocol stress test and were concerning for ischemia. HeartRhythm Case Reports 2015 1, DOI: ( /j.hrcr ) Copyright © 2015 Heart Rhythm Society Terms and Conditions

5 Figure 4 Echocardiogram stress test results revealing polymorphic ventricular tachycardia that developed 4 minutes 6 seconds into a Bruce-protocol stress test (2 minutes 16 seconds after the ST changes described in Figure 3 occurred). HeartRhythm Case Reports 2015 1, DOI: ( /j.hrcr ) Copyright © 2015 Heart Rhythm Society Terms and Conditions

6 Figure 5 A: Coronary angiogram demonstrating a large septal perforator (red arrow). B: During systole, marked myocardial bridging is noted (blue arrow). HeartRhythm Case Reports 2015 1, DOI: ( /j.hrcr ) Copyright © 2015 Heart Rhythm Society Terms and Conditions

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