Hypertrophic obstructive cardiomyopathy

Hypertrophic-LVOT-obstruction_1.gif

Image 4

Clinical History: 
32 year old male with a history of palpitations and a loud cardiac murmur.Diagnosis:
Hypertrophic obstructive cardiomyopathy

MR Technique: 
Cardiac imaging was performed on a 3T MR system (Skyra, Siemens). CINE SSFP images were acquired with a TR/TE of 37.18/1.16, 945Hz/Px bandwidth, 270×360 mm2 field of view, and 153×240 matrix. For reduction of banding artifacts, frequency scouting was implemented. (A-C) Static images through the left ventricle outflow tract (LVOT) during diastole (a), mid systole (B) and end systole (C). See downloadable film.

Imaging Findings:
The myocardium is markedly thickened concentrically. In systole, thickening of the interventricular septum causes obstruction of the LVOT which reaches a maximum diameter of only 0.5 cm. A high signal jet resulting from turbulent flow is seen at this location projecting into the aorta during systole.