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European Journal of Echocardiography 2006 7(6):465-468; doi:10.1016/j.euje.2005.09.002
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Copyright © 2005, The European Society of Cardiology

Dynamic left ventricular outflow tract obstruction in senile cardiac amyloidosis

Farouk Mookadama,*, John H. Haleya, Lyle J. Olsona, Maja Cikesb and Martina Mookadama

aDivision of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, USA
bClinic for Cardiovascular Diseases, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia maja.cikes{at}zg.htnet.hr

Received 31 May 2005; received in revised form 2 September 2005; accepted after revision 11 September 2005.

* Corresponding author. Tel.: +1 507 284 3684; fax: +1 507 266 9142. mookadam.farouk{at}mayo.edu


  Abstract

Dynamic left ventricular outflow tract (LVOT) obstruction is classically seen in hypertrophic obstructive cardiomyopathy (HOCM). This can also be seen in cardiac amyloidosis. We describe a rare case of senile systemic amyloidosis with dynamic LVOT obstruction and concomitant three vessel coronary artery disease presenting with clinical and echocardiographic findings similar to those seen in HOCM. We also highlight the importance of distinguishing the sub-types of amyloidosis so that the appropriate therapy can be offered to patients with cardiac involvement, including coronary artery bypass grafting and septal myotomy/myectomy to relieve LVOT obstruction in the more benign forms of cardiac amyloidosis.

Keywords: Hypertrophic obstructive cardiomyopathy; Left ventricular outflow tract obstruction; Coronary artery disease; Senile amyloidosis; Cardiac amyloidosis


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