Work

Transesophageal Echocardiogram With Isoproterenol to Unmask Previously Occult Left Ventricular Outflow Tract Obstruction

Year: 2025

Type: article

Abstract: Thorough and accurate evaluation of left ventricular outflow tract (LVOT) obstruction is critical in the assessment and management of patients with hypertrophic cardiomyopathy (HCM). Although Doppler echocardiography has become the initial modality to assess LVOT obstruction, it may not identify all patients with labile obstruction. In patients with a high clinical suspicion of LVOT obstruction, further provocative testing is needed. In HCM patients with poor transthoracic echocardiogram windows or who are unable to exercise, isoproterenol-guided transesophageal echocardiogram (TEE) remains a viable option to assess for systolic anterior motion (SAM) and LVOT obstruction. We report 4 individuals in whom there was no obvious SAM or LVOT obstruction at rest but who had severe LVOT obstruction unmasked by isoproterenol-guided TEE.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.103385

Authors: Aakash Bavishi, Kutaiba Nazif, Robyn Bryde, Matthew W. Martinez

Institutions: University of Illinois Chicago, Atlantic Health System

Language: English

Topic: Cardiomyopathy and Myosin Studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850