Adult Presentation of Subaortic Stenosis: Another Great Hypertrophic Cardiomyopathy Mimic

Discrete subaortic stenosis in an adult patient

“…However, the incidence, rate of progression, the treatment options including the timing and technique, and postoperative outcomes in adults have not been fully elucidated [3][4][5][6]. Surgical membranous resection, with or without septal myectomy in patients with DSS, is mostly a successful modality and may provide sufficient relief of LVOTO with low morbidity [1,7,8].…”

8th Decades Presentation of Subaortic Fibrous Membrane with Left Ventricular Outfow Tract Obstruction

“…Also it causes secondary aortic regurgitation. Although it can occur as a isolated lesion it may accompany with any other congenital diseases (1,6,7) such as accessory mitral valve tissue, abnormal left ventricular papillary muscle, anomalous muscular band, bicuspid aortic valve, atrioventricular canal defects, ventricular septal defect, interrupted aortic arch, patent ductus arteriosus, coarctation of the aorta, persistent superior left vena cava (1,6,8,9). DSS causes morphologic abnormalities at LVOT.…”

“…This status includes increased aorto-mitral fibrous distance, arised aorto-septal angle, malalignment ventricular septal defect and increased turbulence (10). Then septal shear stress generate proliferative reaction at endocardium and development of subaortic membrane (3,6,7) At the final producing of left ventricular hypertrophy and aortic regurgitation are inevitable (6,8).…”

“…For example syncope, palpitation, dyspnea, chest pain but it may be asymptomatic too. Diagnosis can be made by echocardiography (6). A cohort study at 4 centers with 149 patients showed that DSS progressed slowly in adult.…”

“…But if the gradient was more than 50mmHg and continue to increase, had severe AR were acceptable predictors for surgery (3). Timing for surgical treatment is controversial (6,8). But if left ventricular hypertrophy and AR started surgery must be the choice (10).…”