LVOT Gradient In HOCM

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Left ventricular outflow tract gradient (LVOT) in hypertrophic obstructive cardiomyopathy (HOCM) is usually measured from the apical five chamber view (apical 5C) in echocardiography. Description and references at: johnsonfrancis...
Initially the apical 5C view is obtained and then the colour Doppler flow mapping (CFM) is done to locate the flow in LVOT. Continuous wave (CW) Doppler cursor is then aligned along the LVOT colour jet of HOCM. The CW jet in HOCM is described as dagger shaped or sickle shaped, unlike the symmetrical tongue shaped jet in fixed obstruction of aortic stenosis. The shape of the jet indicates the dynamic nature of LVOT obstruction in hypertrophic cardiomyopathy. The gradient progressively increases as the systole progresses, to produce this characteristic appearance. The delayed peaking in systole is quite evident (marked by the asterisk).