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• W2007371566 abstract "A 50s male patient with dilated phase of hypertrophic cardiomyopathy received heart transplant after 3 years' waiting with left ventricular assist device. He had been doing well and had no comoplaint till 6 months after transplant, when myocardial biopsy showed acute rejection grade OR, and coronary angiography showed no significant stenosis. However, the patient started to complain dyspnea and chest oppression during exercise after these follow up examination. HolterECG showed no significant ST-T change nor any arrhythmia during symptoms, and treadmill exercise test induced severe symptom without significant ECG change. Nitroglycerin was not effective. Echocardiography showed no wall motion asynergy. However, when he tried valsalva maneuver, midventricular obstruction emerged and intraventricular pressure gradient reached more than 70 mmHg. Dobutamin-stress echo revealed dose-dependent increase of intraventricular pressure gradient and worsening of his daily symptoms. The midventricular obstruction and his symptoms were controlled after administration of be-ta blocker. This is the second case in our center that transplanted heart caused intraventricular obstruction due to its hyperkinetic wall motion. This case suggests that we should keep in mind the possibility of intraventricular obstruction as a cause of patient's symptoms which mimic effort angina or acute rejection after heart trasnplant. A 50s male patient with dilated phase of hypertrophic cardiomyopathy received heart transplant after 3 years' waiting with left ventricular assist device. He had been doing well and had no comoplaint till 6 months after transplant, when myocardial biopsy showed acute rejection grade OR, and coronary angiography showed no significant stenosis. However, the patient started to complain dyspnea and chest oppression during exercise after these follow up examination. HolterECG showed no significant ST-T change nor any arrhythmia during symptoms, and treadmill exercise test induced severe symptom without significant ECG change. Nitroglycerin was not effective. Echocardiography showed no wall motion asynergy. However, when he tried valsalva maneuver, midventricular obstruction emerged and intraventricular pressure gradient reached more than 70 mmHg. Dobutamin-stress echo revealed dose-dependent increase of intraventricular pressure gradient and worsening of his daily symptoms. The midventricular obstruction and his symptoms were controlled after administration of be-ta blocker. This is the second case in our center that transplanted heart caused intraventricular obstruction due to its hyperkinetic wall motion. This case suggests that we should keep in mind the possibility of intraventricular obstruction as a cause of patient's symptoms which mimic effort angina or acute rejection after heart trasnplant." @default.
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• W2007371566 date "2014-10-01" @default.
• W2007371566 modified "2023-09-23" @default.
• W2007371566 title "Case Report of Midventricular Obstruction of Post-transplanted Heart" @default.
• W2007371566 doi "https://doi.org/10.1016/j.cardfail.2014.07.261" @default.
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