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A patient with idiopathic hypertrophic subaortic stenosis (90 mm Hg resting intraventricular gradient) and discrete subaortic stenosis was found to have two separate systolic closing movements of the aortic valve on M mode echocardiography, each movement being associated with a separate systolic ejection murmur. The first closing movement occurred early in systole and was attributed to alterations in flow across the discrete stenosis. The second closing movement coincided with a later systolic murmur and systolic anterior motion of the mitral valve. The case supports the concept that timing of early closing movements of the aortic valve is useful in the diagnosis of subvalvular obstruction.
J F Hagaman, and
C Wolfe, and
E Craige
May 1978,
Nihon geka hokan. Archiv fur japanische Chirurgie,
J F Hagaman, and
C Wolfe, and
E Craige
January 1980,
Indian heart journal,
J F Hagaman, and
C Wolfe, and
E Craige
May 1978,
The American journal of cardiology,
J F Hagaman, and
C Wolfe, and
E Craige
February 1982,
Circulation,
J F Hagaman, and
C Wolfe, and
E Craige
August 1975,
Circulation,
J F Hagaman, and
C Wolfe, and
E Craige
February 1981,
Thorax,
J F Hagaman, and
C Wolfe, and
E Craige
December 1993,
The American journal of gastroenterology,
J F Hagaman, and
C Wolfe, and
E Craige
January 1977,
Indian heart journal,
J F Hagaman, and
C Wolfe, and
E Craige
November 1976,
Zeitschrift fur Kardiologie,
J F Hagaman, and
C Wolfe, and
E Craige
June 1968,
Nordisk medicin,
