Postural Tachycardia Syndrome and Vasovagal Syncope: A Hidden Case of Obstructive Cardiomyopathy without Severe Septal Hypertrophy
Joint Authors
Mayuga, Kenneth A.
Ho, Natalie
Shields, Robert W.
Cremer, Paul
Rodriguez, L. Leonardo
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-04-16
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
A 36-year-old female with symptoms of orthostatic intolerance and syncope was diagnosed with vasovagal syncope on a tilt table test and with postural tachycardia syndrome (POTS) after a repeat tilt table test.
However, an echocardiogram at our institution revealed obstructive cardiomyopathy without severe septal hypertrophy, with a striking increase in left ventricular outflow tract gradient from 7 mmHg at rest to 75 mmHg during Valsalva, with a septal thickness of only 1.3 cm.
Cardiac MRI showed an apically displaced multiheaded posteromedial papillary muscle with suggestion of aberrant chordal attachments to the anterior mitral leaflet contributing to systolic anterior motion of the mitral valve.
She underwent surgery with reorientation of the posterior medial papillary muscle head, resection of the tethering secondary chordae to the A1 segment of the mitral valve, chordal shortening and tacking of the chordae to the A1 and A2 segments of the mitral valve, and gentle septal myectomy.
After surgery, she had significant improvement in her prior symptoms.
To our knowledge, this is the first reported case of obstructive cardiomyopathy without severe septal hypertrophy with abnormalities in papillary muscle and chordal attachment, in a patient diagnosed with vasovagal syncope and POTS.
American Psychological Association (APA)
Mayuga, Kenneth A.& Ho, Natalie& Shields, Robert W.& Cremer, Paul& Rodriguez, L. Leonardo. 2018. Postural Tachycardia Syndrome and Vasovagal Syncope: A Hidden Case of Obstructive Cardiomyopathy without Severe Septal Hypertrophy. Case Reports in Cardiology،Vol. 2018, no. 2018, pp.1-4.
https://search.emarefa.net/detail/BIM-1141368
Modern Language Association (MLA)
Mayuga, Kenneth A.…[et al.]. Postural Tachycardia Syndrome and Vasovagal Syncope: A Hidden Case of Obstructive Cardiomyopathy without Severe Septal Hypertrophy. Case Reports in Cardiology No. 2018 (2018), pp.1-4.
https://search.emarefa.net/detail/BIM-1141368
American Medical Association (AMA)
Mayuga, Kenneth A.& Ho, Natalie& Shields, Robert W.& Cremer, Paul& Rodriguez, L. Leonardo. Postural Tachycardia Syndrome and Vasovagal Syncope: A Hidden Case of Obstructive Cardiomyopathy without Severe Septal Hypertrophy. Case Reports in Cardiology. 2018. Vol. 2018, no. 2018, pp.1-4.
https://search.emarefa.net/detail/BIM-1141368
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1141368