RESUMO
Abstract This paper presents a case study of a 30-year-old male patient with dyspnea on exertion had echocardiographic diagnosis of aortic subvalvar stenosis. Discrete mitral regurgitation and aortic valve dysplasia with mild to moderate insufficiency and hypertrophic cardiomyopathy were also noted. During surgery, a rare condition was identified: presence of papillary muscle anomaly associated with the subaortic membrane as a cause of obstruction of the left ventricular outflow tract. With the resection of these structures and a mitral valve annuloplasty, the patient evolved with a significant improvement of clinical condition and heart failure, with no residual mitral insufficiency.
Assuntos
Humanos , Masculino , Adulto , Músculos Papilares/anormalidades , Obstrução do Fluxo Ventricular Externo/cirurgia , Estenose Subaórtica Fixa/complicações , Cardiopatias Congênitas/complicações , Músculos Papilares/cirurgia , Obstrução do Fluxo Ventricular Externo/etiologia , Ecocardiografia , Estenose Subaórtica Fixa/cirurgia , Estenose Subaórtica Fixa/diagnóstico por imagem , Anuloplastia da Valva Mitral , Cardiopatias Congênitas/cirurgia , Cardiopatias Congênitas/diagnóstico por imagemRESUMO
We herein report a rare case of subaortic stenosis in association with a previous tetralogy of Fallot (TOF) surgical repair, which was not taken into account as a differential diagnosis. Echocardiography plays a pivotal role in identification of this rare combination. Therefore, echocardiography should be performed periodically during follow-up of patients with surgically corrected TOF. Given the clinical complications that can result from subaortic stenosis (i.e., aortic regurgitation and infective endocarditis), early and aggressive management of this rare combination should be performed.