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Use of Doppler echocardiography and amyl nitrite inhalation to characterize left ventricular outflow obstruction in hypertrophic cardiomyopathy.

Publication ,  Journal Article
Sheikh, KH; Pearce, FB; Kisslo, J
Published in: Chest
February 1990

The presence of left ventricular outflow tract obstruction (LVOTO) of either a resting or dynamic nature may have important therapeutic and prognostic implications in patients with hypertrophic cardiomyopathy (HCM). Doppler echocardiograms combined with amyl nitrite (Amyl) inhalation were performed in 333 consecutive patients referred for suspected HCM to diagnose and categorize the nature and severity of LVOTO. Hypertrophic cardiomyopathy was present by 2-D and M-mode criteria in 145/333 (44 percent) patients. Normal limits of resting and post-Amyl continuous wave Doppler peak left ventricular outflow tract velocities were established in 15 subjects with completely normal 2-D and Doppler echocardiograms. Based on these criteria, of the 145 patients with HCM, 63 (43 percent) were classified as having resting LVOTO, peak velocity 4.2 +/- 1.3 m/s. Among 82 patients with HCM without resting LVOTO, 47 (57 percent) received Amyl. Latent LVOTO was provoked in 25/47 (53 percent), peak post-Amyl velocity 4.5 +/- 1.2 m/s. The remaining 22 (47 percent) had nonobstructive HCM, as indicated by no significant increase in post-Amyl velocity. Among a total 62 subjects receiving Amyl, none experienced serious morbidity or mortality. Doppler echocardiography, in conjunction with Amyl inhalation in selected patients, is a useful noninvasive method to diagnose and categorize patients with HCM according to the nature and severity of LVOTO.

Duke Scholars

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

February 1990

Volume

97

Issue

2

Start / End Page

389 / 395

Location

United States

Related Subject Headings

  • Ventricular Outflow Obstruction
  • Respiratory System
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography, Doppler
  • Cardiomyopathy, Hypertrophic
  • Amyl Nitrite
  • Aged
 

Citation

APA
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Sheikh, K. H., Pearce, F. B., & Kisslo, J. (1990). Use of Doppler echocardiography and amyl nitrite inhalation to characterize left ventricular outflow obstruction in hypertrophic cardiomyopathy. Chest, 97(2), 389–395. https://doi.org/10.1378/chest.97.2.389
Sheikh, K. H., F. B. Pearce, and J. Kisslo. “Use of Doppler echocardiography and amyl nitrite inhalation to characterize left ventricular outflow obstruction in hypertrophic cardiomyopathy.Chest 97, no. 2 (February 1990): 389–95. https://doi.org/10.1378/chest.97.2.389.
Sheikh, K. H., et al. “Use of Doppler echocardiography and amyl nitrite inhalation to characterize left ventricular outflow obstruction in hypertrophic cardiomyopathy.Chest, vol. 97, no. 2, Feb. 1990, pp. 389–95. Pubmed, doi:10.1378/chest.97.2.389.
Journal cover image

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

February 1990

Volume

97

Issue

2

Start / End Page

389 / 395

Location

United States

Related Subject Headings

  • Ventricular Outflow Obstruction
  • Respiratory System
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography, Doppler
  • Cardiomyopathy, Hypertrophic
  • Amyl Nitrite
  • Aged