Dynamic left ventricular outflow obstruction is a less well-known mechanical complication of acute myocardial infarction. Early diagnosis is important because initiation of proper manage ment and avoidance of precipitating factors can lead to complete recovery. A patient is described who presented with acute myocardial infarction and in whom significant left ventric ular outflow tract obstruction developed. Adequate therapy with β blockers and calcium channel blockers led to complete resolution of the obstruction.
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References
1.
Safi AM, Tang A., Feit A., et al: Ruptured mitral valve chordae and hypertrophic subaortic stenosis in a patient with hypertensive hypertrophic cardiomyopathy. Cardiovasc Rev Rep22:52-57, 2001.
2.
Deligonul U. , Uppstrom E., Penick D., et al: Dynamic left ventricular outflow tract obstruction induced by pericardial tamponade during acute anterior myocardial infarction. Am Heart J121:190-194, 1991.
3.
Yuki K., Kodma Y., Onda J., et al: Coronary vasospasm following subarachnoid hemorrhage as a cause of stunned myocardium: Case report. J Neurosurg75:308-311, 1991.
4.
Villareal RP , Achari A., Wilansky S., et al: Anteroapical stunning and left ventricular outflow tract obstruction . Mayo Clin Proc76:79-83, 2001.
5.
Grines CL, Topol EJ, Califf RM, et al: Prognostic implications and predictors of enhanced regional wall motion of the noninfarcted zone after thrombolysis and angioplasty therapy of acute myocardial infarction. TAMI Study Group. Circulation80:245-253, 1989.
6.
Joffe II, Riley MF, Katz SE, et al: Acquired dynamic left ventricular outflow tract obstruction complicating acute anterior myocardial infarction: Serial echocardiographic and clinical evaluation. J Am Soc Echocardiogr10:717-721, 1997.
7.
Bartunek J., Vanderheyden M., De Bruyne B.: Dynamic left ventricular outflow obstruction after anterior myocardial infarction: A potential mechanism of myocardial rupture. Eur Heart J16:1439-1442, 1995.
8.
Tse RW, Masindet S., Stavola T., et al: Acute myocardial infarction with dynamic outflow obstruction precipitated by intra-aortic balloon counterpulsation. Cathet Cardiovasc Diagn39:62-66, 1996.
9.
First International Study of Infarct Survival Collaborative Group: Randomised trial of intravenous atenolol among 16,027 cases of suspected of acute myocardial infarction: ISIS-1. Lancet2:57-66, 1986.
10.
Yusuf S., Sleight P., Held P., et al: Routine medical management of acute myocardial infarction: Lessons from overviews of recent randomized controlled trails. Circulation82(suppl II):II-117-II-134, 1990.
