Images Genevieve Carbonatto   

Parasternal long axis (PLAX) of the left ventricle demonstrating asymmetric septal hypertrophy, compare the thickness of the interventricular septum, (IVS) in diastole with the infero-lateral (posterior) LV wall.  The IVS / LVPW > 1.3 : 1.  The LV cavity almost completely obliterates, “kissing walls” suggesting hypovolaemia.  The left atrium, (LA) is dilated.  There is a small pericardial effusion posteriorly and a trivial pericardial effusion anteriorly.  Calcification of the posterior mitral annulus is also visualised. There is some pericardial fat anterior to the RV anterior wall.

Parasternal short  axis (PSAX) of the left ventricle at the level of the papillary muscles with complete cavity obliteration. Again compare the thickness of the antero-septum to the infero-lateral wall.  The small circumferential pericardial effusion is seen as is the pericardial fat anterior to the RV anterior  wall.

Apical 4-chamber view during fluid loading, (bubbles in the right heart). LV walls are hypertrophied and “kissing” suggesting more fluid can be given.  Dilated left atrium. Small pericardial effusion seen mainly around the right atrium.  The posterior mitral annular calcification can again be seen.



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