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Total relief of severe left ventricular outflow obstruction after spontaneous rupture of chordae tendineae in a patient with hypertrophic cardiomyopathy
  1. A Q Araujo1,
  2. W V Azeredo2,
  3. E Arteaga1,
  4. C Mady1
  1. 1Heart Institute (Incor), University of Sao Paulo Medical School, Sao Paulo, Brazil
  2. 2Espirito Santo Heart Institute, Brazil
  1. Correspondence to:
    Dr Aloir Q Araujo
    Av Enéas Carvalho Aguiar, 44, 05403-900 Sao Paulo, Brazil; aloirqueirozcardiol.br

Abstract

In hypertrophic cardiomyopathy (HCM), rupture of mitral chordae tendineae is infrequent and causes acute haemodynamic deterioration. A 38 year old male patient had chordae rupture leading to prolapse of both mitral leaflets and severe regurgitation, without change in symptomatic status. One year before, he had had mild mitral regurgitation and a resting left ventricle outflow tract of 105 mm Hg that disappeared in the present evaluation. In this unique case, worsening of mitral regurgitation was counterbalanced by total relief of the severe obstruction. This case report highlights the role of the mitral valve apparatus in the genesis of obstruction in HCM, further stimulating surgical techniques in which mitral repair can be the main procedure.

  • HCM, hypertrophic cardiomyopathy
  • LVOT, left ventricular outflow tract
  • chordae tendineae
  • hypertrophic cardiomyopathy
  • transoesophageal echocardiography
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