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LVOTO from abnormal MV chordae w/o hypertrophy
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LVOTO from abnormal MV chordae w/o hypertrophy

Hi,

I'm having trouble finding out any information about my condition described as:

"… quite abnormal appearance of the anterior mitral valve leaflet chordae with significant redundancy and systolic anterior motion.  In addition, patient has post-exercise left ventricular outflow tract obstruction which is at least 45 mmHg and may be as high as 115mmHg at peak exertion."

Most people who have LVOTO also suffer from hypertrophic cardiomyopathy, but I do not.  From my cardiologist's report from an echo, stress echo and MRI:

- hyperdynamic left ventricle w/ EF over 65%
- no evidence of hypertrophic cardiomyopathy (max LV wall thickness of 10mm, apical septum at 9mm, apical lateral wall at 8mm, significant apical thinning at true apex less than 4mm)
- resting systolic BP: 133
- peak exercise systolic BP: 205 mm Hg
- no arrhythmia after exercise
- EKG sinus rhythm w/ biphasic t-waves in V3/V4 and inverted t-waves in III and aVF, and early repolarization pattern
- soft mid-peaking systolic murmur best heard at the base with repeated squat to stand
- patient complains of

- normal CTA test
- normal 48-hr Holter test

There's no fancy WebMD page for this condition- just wanted to know how serious this condition is. How safe is it for me to exercise (no idea what 45mmHg - 115mmHg of obstruction means)? And if there's anything I should look out for or in terms of critical symptoms.

Thanks in advance!
Avatar dr f tn
Hi, with a mitral valve having significant redundancy, the ejection fraction is normal and there is no evidence of ventricular hypertrophy. The murmur it could be a flow murmur, and considering the hyperdynamic left ventricle, it could occur due to causes like anemia or hyperthyroidism. The findings are correlated with clinical symptoms. So, please discuss this with your doctor am sure he will provide further assistance. Regards.
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