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Case Reports
. 2023 Mar 2;11(3):e7010.
doi: 10.1002/ccr3.7010. eCollection 2023 Mar.

Intraventricular gradients-When we have to "exercise" our minds: A case report

Nuno Cotrim  1 , Pedro Silva Cunha  2 , Jorge Guardado  3 , Carlos Cotrim  3   4 , Luís Baquero  4
Affiliations
Case Reports

Intraventricular gradients-When we have to "exercise" our minds: A case report

Nuno Cotrim et al. Clin Case Rep. .

Abstract

Increased intraventricular pressure gradients due to dynamic left ventricular outflow tract obstruction during exercise have long been known to cause different symptoms. Exercise stress echocardiography is fundamental in the diagnostic approach of symptoms presenting during exercise. We hypothesize on the possible pathophysiological mechanisms responsible for our patient's syncopal episodes.

Keywords: exercise stress echocardiography; intraventricular gradients; syncope; systolic anterior motion of the mitral valve.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Normal twelve‐lead electrocardiogram, at rest.
FIGURE 2
FIGURE 2
Effort‐induced ST‐segment depression in twelve‐lead electrocardiogram during exercise (1.5 mm in the inferior leads, DI and V4‐V6).
FIGURE 3
FIGURE 3
Intraventricular gradient of 150 mmHg with an end‐systolic peak measured with continuous‐wave doppler and systolic anterior motion (SAM) of the mitral valve after exercise in the upright position.
See this image and copyright information in PMC

References

    1. Brignole M, Moya A, de Lange FJ, et al. 2018 ESC guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39(21):1883‐1948. doi:10.1093/eurheartj/ehy037 - DOI - PubMed
    1. Hatoum T, Sheldon R. A practical approach to investigation of syncope. Can J Cardiol. 2014;30(6):671‐674. doi:10.1016/j.cjca.2014.03.043 - DOI - PubMed
    1. van Dijk JG, Wieling W. Pathophysiological basis of syncope and neurological conditions that mimic syncope. Prog Cardiovasc Dis. 2013;55(4):345‐356. doi:10.1016/j.pcad.2012.10.016 - DOI - PubMed
    1. Ungar A, Del Rosso A, Giada F, et al. Early and late outcome of treated patients referred for syncope to emergency department: the EGSYS 2 follow‐up study. Eur Heart J. 2010;31(16):2021‐2026. doi:10.1093/eurheartj/ehq017 - DOI - PubMed
    1. Akdemir B, Krishnan B, Senturk T, Benditt DG. Syncope: assessment of risk and an approach to evaluation in the emergency department and urgent care clinic. Indian Pacing Electrophysiol J. 2015;15(2):103‐109. doi:10.1016/j.ipej.2015.07.005 - DOI - PMC - PubMed

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