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added by Emmel

Posted By: Emmel (1666 days ago)

Hallo Pablo,

sorry about my late answer.

In this
case there was no significant gradient in rest and under moderat
physical stress (about 75 Watt; peripheral exhaustion of that patient;
heart rate about 120/min). Actually we found NO amyoloidose (you are
right!) in biopsy of rectal mucosa but a new rheumatic-factor-negative
rheumatic disease (I don´t think that is the cause of that
LV-Hypertrophy). So overall I think that is a HNOCM. The mitral
doppler pattern showed a disturbance of relaxation (not of
Best wihes,


Posted By: ohtusabes (1692 days ago)

Great clips Jörg. The data that orient to infiltrative disease like
amyloidosis is ECG with low voltage...it is unusual that with this
grade of parietal hipertrophy ECG don´t have very large QRS complex.
Other signs will be LA enlargement and mitral doppler pattern, that
must have a restrictive physiology. Syncopes can be because of LVOT
obstruction? is there some gradiente (at basal or evoked?). Best

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about 75 y old patient with known hypertension and stable coronary disease (LAD, condition after PCI > 5 y ago). The patient was admitted to our hospital with several collapses and syncopes. in ECG we could see a peripheral low voltage amplitudes (NOT in Wilson). in TTE I saw a distinct LV (and RV) hypertrophy (IVSDd 21 mm!) with almost normal LV function. The echotexture seems very unusual, so that I suspect that there is any underlaying systemic disease (amyloidose?,). What do you think?

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