2012年1月18日 · Systolic anterior motion (SAM) of the mitral valve (MV) can be a life-threatening condition. The SAM can result in severe left ventricular outflow tract obstruction and/or mitral regurgitation and is associated with an up to 20% risk of sudden death (which is substantially lower in hypertrophic cardiomyopathy (HCM)).

Patients who developed SAM after the repair were systematically treated according to the algorithm. The intraoperative algorithm first involved medical management techniques, followed by surgical correction for significant SAM (mild or greater mitral regurgitation, left ventricular outflow tract gradient > 50 mm Hg).

2018年1月16日 · We can accomplish this by administering fluids, elevating the legs to increase venous return, and using agents like beta blockers for the dual benefit of negative inotropy and negative chronotropy. By keeping the heart rate on the low-normal side, we prolong diastole and allow the heart to fill more to alleviate the LVOT obstruction.

Systolic anterior motion (SAM) of the mitral chordae tendineae (chordal SAM) is commonly observed with septal hypertrophy in hypertrophic cardiomyopathy (HCM) and may cause severe hypotension by obstructing the left ventricular outflow tract (LVOT) during the systole phase.

Systolic anterior motion (SAM) is a postoperative complication experienced by patients undergoing mitral valve repair. The incidence of SAM after mitral valve repair ranges from 5 to 10%. Early recognition of the signs and symptoms of SAM is …

Initial management strategy of the patient with SAM diagnosis includes treatment with beta-adrenoceptor blockade, volume loading, and increase in afterload to correct SAM in the vast majority of patients.

2017年2月1日 · Among non-HCM SAM, valvular SAM showed a significant symptom, higher LVOT-PG, and more pronounced mitral regurgitation than chordal SAM. The systolic anterior motion of the mitral valve (SAM) was initially considered a typical feature of hypertrophic cardiomyopathy (HCM) with left ventricular outflow tract (LVOT) obstruction [1], [2].

2018年4月3日 · Symptoms arising from moderate SAM should be managed with medical treatment. Rarely, the most severe form of SAM is manifested in association with the LVOT obstruction and severe MR, which results in hemodynamic collapse with low …

This article describes what the clinician needs to know about SAM ranging from pathophysiological mechanisms and imaging modalities to conservative (medical) and surgical approaches and their respective outcomes. A stepwise approach is advocated consisting of medical therapy, followed by aggressive volume loading and beta-adrenoceptor blockade.

While the presence of SAM is often due to the pathology of the mitral valve, chordal SAM has also been described in case series and reports. Imaging modalities, such as transesophageal echocardiography (TEE) and cine cardiac magnetic resonance imaging (MRI), are valuable in identifying anatomic variants of the mitral valve apparatus associated ...