Cardiac catheterization in a patient with obstructive hypert
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A 35-year-old man sought medical care for recurrent syncope episodes related to moderate exertion in the past 2 months. Upon physical examination, the presence of a rude systolic murmur on the left sternal border was identified. The echocardiogram disclosed a moderate increase in the left atrium and significant hypertrophy of the interventricular septum with an estimated maximum diastolic diameter of 31 mmHg and a maximum left ventricular outflow tract gradient of 56 mmHg.The coronary angiography showed extrinsic compression of the first diagonal branch and septal arteries. Simultaneous ventriculography of both ventricles disclosed significant hypertrophy of the medial and basal portions of the interventricular septum with left ventricular outflow tract obstruction. The patient was submitted to septal myectomy with no complications, with a significant reduction in the intraventricular gradient...

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