Abstract
A 69-year-old woman was admitted our hospital due to acute cerebral infarction. Transthoracic
echocardiography showed massive left ventricular (LV) hypertrophy with small ventricles
and normal LV ejection fraction. Apical 4-chamber and longitudinal images showed mild
LV obstruction. After treatment for hypertension, her blood pressure decreased from
208/129 mmHg to 150/68 mmHg. Pulsed Doppler echocardiography revealed new paradoxical
flow at the mid-ventricle. Decreased LV pressure following treatment with antihypertensive
medications may have contributed to the development of early mid-ventricular obstruction
and paradoxical flow in the present case.
Learning objective
In mid-ventricular obstructive cardiomyopathy, apical aneurysm may be present and
cause serious complications such as rupture of the apex and sudden death. In the present
case, apical aneurysm newly developed after treatment for hypertension was suggested
by advent of paradoxical flow. This case suggests that intraventricular hemodynamic
change may become a trigger of paradoxical flow and apical aneurysm, becoming a risk
of serious complication.
Keywords
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Article info
Publication history
Published online: January 25, 2023
Accepted:
December 27,
2022
Received in revised form:
November 23,
2022
Received:
September 1,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
