Images in Cardiology: SubvalvularPulmonic Stenosis

摘要

A 46-year-old Hispanic woman with a history of a childhood murmur and longstanding dyspnea on exertion presented with shortness of breath at rest. She was transferred to our institution for evaluation of suspected pulmonic stenosis. The pulmonic valve was poorly visualized by transfhoracic echo-cardiogram; however, pulse wave Doppler revealed a gradient of > 100 mmHg across the right ventricular outflow tract (RVOT), suggesting pulmonic or subpulmonic stenosis. He-modynamic tracings from right and left heart catheterization demonstrated a gradient of 125 mmHg across the RVOT (Fig.1). Pulmonary artery angiography revealed an angiographical-ly normal pulmonary artery. Right ventriculography revealed significant subpuhnonic stenosis (Fig. 2).