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What causes outflow tract obstruction in hypertrophic cardiomyopathy?
  1. Steve Ommen (ommen.steve{at}
  1. Mayo Clinic, United States
    1. Rick Nishimura (rnishimura{at}
    1. Mayo Clinic, United States


      The first descriptions of patients impacted with what has become known as hypertrophic cardiomyopathy occurred roughly 50 years ago1,2. Careful examination involving both auscultatory and palpatory physical findings and, subsequently, invasive hemodynamics led to the appreciation of dynamic subvalvular obstruction. Thus began an era of intense hemodynamic assessment into this fascinating condition which has come to be appreciated in most cases as a disease of not only left ventricular hypertrophy but also dynamic impedance to left ventricular ejection. There has also been a considerable degree of controversy over the existence of, mechanisms of, and treatments for this unique type of hemodynamic abnormality.

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