Echocardographic findings in discrete subaortic stenosis associated with infective endocarditis of the aortic valve

The echocardiographic findings of three patients with discretesubaortic stenosis associated with infective endocarditis arereported. This disorder was suspected because of early systolicaortic valve partial closure followed by a fine fluttering throughoutsystole in each case. Narrowing of the left ventricular outflowtract as judged by the left ventricular outflow tract/aorticroot ratio was of limited diagnostic value because the presenceof echoes of aortic vegetations at this level in two cases preventedaccurate measurement of the outflow tract. This study suggeststhat a careful echocardiographic study may detect discrete subaorticstenosis in the presence of aortic valve endocarditis. Thus,whenever left ventricular outflow obstruction is associatedwith infective endocarditis, early systolic aortic valve partialclosure followed by a fine fluttering throughout systole shouldbe carefully sought