LVOT gradient in HOCM – Doppler echocardiogram

LVOT gradient in HOCM – Doppler echocardiogram Left ventricular outflow tract gradient in hypertrophic obstructive cardiomyopathy Left ventricular outflow tract gradient (LVOT) in hypertrophic obstructive cardiomyopathy (HOCM) is usually  measured from the apical five chamber view (apical 5C) in echocardiography. Initially the apical 5C view is obtained and then the colour Doppler flow mapping (CFM) is done to locate the flow in LVOT. Continuous wave (CW) Doppler cursor is then aligned along the LVOT colour jet of HOCM. The CW jet in HOCM is described as dagger shaped or sickle shaped, unlike the symmetrical tongue shaped jet in fixed obstruction of aortic stenosis. The shape of the jet indicates the dynamic nature of LVOT obstruction in hypertrophic cardiomyopathy. The gradient progressively increases as the systole progresses, to produce this characteristic appearance. The delayed peaking in systole is quite evident (marked by the asterisk). Dynamic variation of LVOT gradient in hypertrophic cardiomyopathy (HCM) Dynamic variation of LVOT gradient in hypertrophic cardiomyopathy (HCM) can be quite variable. When the left ventricular cavity is small due to hypovolemia or dehydration, the gradient can rise significantly. Various manoeuvers like isometric handgrip, Valsalva maneuver and standing can bring out the gradient well when it is low in the basal state. But getting a good echocardiographic image during these maneuvers may be challenging. The dynamic variation in L...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Echocardiogram Library Echocardiography Dynamic variation of LVOT gradient in hypertrophic cardiomyopathy Source Type: blogs