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Fig. 4 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 4

From: Delayed myocardial enhancement in children with different types of cardiomyopathy: a diagnostic and prognostic tool

Fig. 4

af Residual HCOM with LVOT obstruction by systolic anterior motion of the mitral valve (SAM) and anomalous papillary muscle: Nine-year-old male patient presented with status post myoctomy with residual HOCM. Cine steady-state free precession (SSFP) in short axis (a, b) views, shows residual focal asymmetrical hypertrophy of antero-septal segment of left ventricle (site of previous myomectomy) with maximum thickness about 20 mm in end diastole image (a) and end systole image (b) with hyper dynamic EF (73%) normal both (EDV = 86.4 ml and ESV = 35.7 ml). Three-chamber view (e) in the same patient shows thickening of the basal ventricular septum causing LVOT narrowing. LV contraction leads to flow acceleration in the narrowed LVOT with visible area of signal void (arrow, e) with subsequent pressure drops cause SAM and leading to mitral regurgitation (MR) (black arrow, e). f Short axis plane in the same patient showing the extra (anomalous) papillary muscle

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