Background
Subaortic obstruction by a membrane or systolic anterior motion of the mitral valve leaflets is usually suspected in young patients, especially if the anatomy of the aortic valve is not clearly stenotic and unexplained left ventricular hypertrophy exists in the context of high transaortic gradients.
Main body
In certain circumstances, some patients show both aortic and subaortic stenotic lesions of variable severity. Doppler echocardiography can help in grading severity in the case of single-level obstruction but not in patients with multilevel obstruction where the continuity equation is of no value. Three-dimensional (3D) echocardiography allows "en-face" visualization of each level of the aortic valve and subaortic tract; in addition, direct planimetry of the areas can be done using multiplanar reformatting.
Conclusions
Accordingly, 3D echocardiography plays a crucial role in the assessment in patients with multilevel left ventricular outflow tract obstruction as it can accurately delineate the location and size, and severity of the stenosis.
A 57-year-old man presented with exertional dyspnea. An early systolic murmur was heard over the aortic areas 2D and 3D. Echocardiography revealed unicuspid, unicommissural aortic valve (UAV) with a characteristic "teardrop" lateral orifice (Figure 1A) and moderate
BACKGROUND and AIM:Recent data suggested that one third of patients meeting conventional electrocardiographic (ECG) criteria for left bundle branch block (LBBB) may be misdiagnosed and new, stricter, ECG criteria for LBBB have been proposed (Strauss's criteria). Accordingly, we used two-dimensional speckle tracking echocardiography (2DSTE), to compare left ventricular (LV) mechanics in patients with LBBB according to conventional versus Strauss's ECG criteria for LBBB.
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