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Chest, Vol 69, 694-696, Copyright © 1976 by American College of Chest Physicians

ARTICLES

Systolic anterior motion of the mitral valve without asymmetric septal hypertrophy

BH Bulkley and NJ Fortuin

This report describes a patient with echocardiographic systolic anterior motion of the mitral valve causing the anterior mitral leaflet to contact the septum in systole. At necropsy a normal nonhypertrophied heart with normal-sized ventricular cavities and a normal outflow tract and mitral valve was found. Thus, asymmetric septal hypertrophy and abnormal mitral valvular placement are not requisites for systolic anterior motion of the mitral valve. During systole, a marked forward movement of the anterior mitral leaflet developed in our patient in the setting of hypovolemia and continuous intravenous administration of pressor drugs, suggesting, rather, that systolic anterior motion reflects a small, vigorously contracting ventricular cavity and that such dynamic subaortic obstruction is not pathognomonic of idiopathic hypertrophic subaortic stenosis.


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G. Luckner, J. Margreiter, S. Jochberger, V. Mayr, T. Luger, W. Voelckel, A. J. Mayr, and M. W. Dunser
Systolic Anterior Motion of the Mitral Valve with Left Ventricular Outflow Tract Obstruction: Three Cases of Acute Perioperative Hypotension in Noncardiac Surgery
Anesth. Analg., June 1, 2005; 100(6): 1594 - 1598.
[Abstract] [Full Text] [PDF]


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