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Beta-blocker stress echocardiography in an aortic stenosis patient with associated left ventricular outflow tract obstruction
Authors:Masataka Sugahara  Akiko Goda  Mitsuru Masaki  Ayumi Nakabo  Shohei Fujiwara  Miho Fukui  Kanako Itohara  Shinichi Hirotan  Kazuo Komamura  Masaaki Kawabata-Lee  Takeshi Tsujino  Tohru Masuyama
Affiliation:1. Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
2. Department of Pharmacy, School of Pharmacy, Hyogo University of Health Science, Kobe, Japan
Abstract:An 80-year-old man visited our hospital because of dyspnea on exertion from 6 months ago. Echo Doppler study showed severe calcification in the aortic valve with restricted movement and the sigmoid septum causing obstruction at the LV outflow tract (LVOT). Considering the aortic valve area (AVA) might have been inaccurately estimated, we carried out beta-blocker stress echocardiography. The transaortic pressure gradient and AVA were respectively calculated as 52 mmHg and 0.90 cm2 before propranolol administration and as 64 mmHg and 0.86 cm2 after propranolol administration. Thus, beta-blocker stress echocardiography may provide an accurate assessment of AS if the LVOT obstruction is concomitant.
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