Giant T-wave Inversions in Apical Hypertrophic Cardiomyopathy
Systolic anterior motion of the mitral valve (SAM) first was described in the 1960s in patients with hypertrophic cardiomyopathy, and later following mitral valve (MV) annuloplasty, in the 1970s.1,2 Since then, it has been shown that left ventricular outflow tract obstruction (LVOTO) from SAM has a plethora of other predisposing risk factors. These risk factors include, but are not limited to, hypertrophic cardiomyopathy, anterior and medial displacement of the left ventricular papillary muscles, redundant MV leaflet tissue, and after mitral valve repair (MVR) and aortic valve replacement (AVR) surgeries.
Noel Marie Pio Samy, Chitra Rajeswari Thangaswamy, Valliyoor Ramamoorthy Srivats, Thirumurugan ArikrishnanIndian Journal of Anaesthesia 2020 64(8):725-727
We report a case of tetralogy of fallot with subaortic septal bulge who developed SAM of the anterior mitral leaflet, intraoperatively, after resection of a subaortic membrane. PMID: 32687100 [PubMed - as supplied by publisher]
PMID: 32275049 [PubMed - in process]
HYPERTROPHIC CARDIOMYOPATHY (HCM) is a relatively common inherited cardiac disease characterized by asymmetrical left ventricle (LV) wall thickening. Because left ventricular outflow tract (LVOT) obstruction occurs in HCM and can lead to catastrophic circulatory collapse, its prevention is one of the most important issues in perioperative circulatory management. LVOT obstruction is induced or aggravated by a decrease in the preload or afterload; an increase in cardiac contractility or heart rate; or any combination of these factors.
Sangeeta Khanna, Krishna Prasad, Vipin J Sharma, Nitul M BewalIndian Journal of Anaesthesia 2019 63(12):1041-1042
Costello syndrome is a rare genetic disorder characterized by mental and growth retardation and distinctive coarse facies. A significant proportion of patients with Costello syndrome have hypertrophic cardiomyopathy, papillomata, and malignant tumors. General anesthesia practice, especially airway and cardiac management, in patients with Costello syndrome may be complicated by anatomical features and cardiac abnormalities. There have been several reports on the anesthetic management of children with Costello syndrome, but few have reported on the anesthetic management of adults with Costello syndrome. In adults, careful pr...
We report our use of angiotensin II infusion for vasoplegic shock in a combined heart and liver transplantation recipient with hypertrophic cardiomyopathy and systolic anterior motion of the mitral leaflet (SAM). A 34-year-old woman (60 kg) with complex congenital heart disease, failing Fontan physiology dependent on pharmacologic inotropy, and cardiac cirrhosis underwent combined orthotopic heart and deceased-donor liver transplantation. The cause of death in the donor was aneurysmal subarachnoid hemorrhage.
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health probl...
Ranjith K Sivakumar, Sakthirajan Panneerselvam, Subashree Das, Priya RudingwaIndian Journal of Anaesthesia 2019 63(4):321-323