RT Journal Article
SR Electronic
T1 56-year-old lady with transaortic gradient
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2017-312734
DO 10.1136/heartjnl-2017-312734
A1 Roberto Spina
A1 Arjun Iyer
A1 Paul Jansz
YR 2018
UL http://heart.bmj.com/content/early/2018/04/13/heartjnl-2017-312734.abstract
AB Clinical introduction A 56-year-old lady with a background of hypertension was admitted to our institution with acute pulmonary oedema. She reported gradual and increasingly severe dyspnoea on exertion over the preceding 12 months and, prior to presentation, her exercise tolerance was restricted to one flight of stairs. On transthoracic echocardiography during the index admission, left ventricular size and systolic function were normal, and peak and mean transaortic gradients were 67 mm Hg and 33 mm Hg, respectively, with a peak velocity of 3.9 m/s. No aortic incompetence or other significant valvular abnormality was noted. A transoesophageal echocardiogram was performed. Figure 1 depicts the mid-oesophageal parasternal long-axis view. What is the explanation behind the significant transaortic gradient?Figure 1 Transoesophageal echocardiogram, mid-oesophageal long-axis view at 135 degrees.Question What is the explanation behind the significant transaortic gradient?Ventricular septal defect Supravalvular aortic stenosisAortic valvular stenosisSubaortic membraneHypertrophic obstructive cardiomyopathy