Mid-cavity obstruction in apical hypertrophy: Doppler evidence of diastolic intraventricular gradient with higher apical pressure.
Overview
abstract
Three cases of apical left ventricular hypertrophy demonstrating a sequestered small left ventricular apical cavity with complete systolic and partial diastolic intraventricular obstruction are described. Doppler studies revealed that flow from the apical chamber is aborted during early systole with further emptying during diastole through a narrow intraventricular channel, where a diastolic high-velocity jet (greater than or equal to 2.5 m/sec) directed from apex to base was localized. This indicated a significantly higher pressure in early diastole in the sequestered apical cavity. Filling of the apical chamber occurred late in diastole and during isovolumic ventricular contraction. The observations by Doppler of complete intraventricular systolic and partial diastolic obstruction in apical hypertrophy are new and may have significant clinical implications.
