Level at which left ventricular outflow gradient becomes hemodynamically significant – Cardiology MCQ – Answer

Level at which left ventricular outflow gradient becomes hemodynamically significant:

Correct answer: b) 50 mm Hg.

But for defining left ventricular outflow tract obstruction (LVOTO), a peak left ventricular outflow tract (LVOT) pressure gradient of 30 mm Hg or more at rest or during physiological provocative measures like Valsalva manoeuvre, standing or exercise is enough.

Symptomatic patients with LVOTO gradient 50 mm Hg or above in spite of maximally tolerated medications will be considered for septal reduction therapies like septal myectomy and alcohol septal ablation in the case of hypertrophic obstructive cardiomyopathy.

Reference

1. Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014 Oct 14;35(39):2733-79.

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