case_images: PMC11806472_01
case_images: Transesophageal echocardiography: systolic anterior motion of the elongated anterior mitral valve leaflet, resulting in obstruction of the left ventricular outflow tract (left panel) and significant mitral regurgitation (right panel).
case_images: 10.1177_03000605251315345-fig1.jpg
case_images: PMC11806472_01_10.1177_03000605251315345-fig1.jpg
case_images: fig1-03000605251315345
case_images: Rapid bedside transthoracic echocardiography (TTE) and transoesophageal echocardiography demonstrated preserved ejection fraction (EF) in an asymmetrically hypertrophic left ventricle (LV) without regional wall motion abnormalities but with severe mitral regurgitation (MR) due to systolic anterior motion (SAM) of the anterior leaflet and dynamic LVOTO (Figure 1).
case_images: Selective coronary angiography: demonstration of nonobstructive coronary artery disease.
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case_images: fig2-03000605251315345
case_images: Coronary angiography performed during ECMO implantation ruled out obstructive coronary artery disease (Figure 2).
case_images: PMC11806472_02
case_images: Transthoracic echocardiography: asymmetrical hypertrophy of the left ventricle (16 mm at the basal septum), with severe provoked obstruction in the left ventricular outflow tract following administration of a low dose of nitroglycerin.
case_images: 10.1177_03000605251315345-fig3.jpg
case_images: PMC11806472_02_10.1177_03000605251315345-fig3.jpg
case_images: fig3-03000605251315345
case_images: A follow-up TTE showed normalized left ventricular function without regional wall motion abnormalities but with persistent severe dynamic LVOTO (peak gradient approximately 200 mmHg) provoked by a small dose of nitroglycerin (Figure 3).