Case 5 — Two-Dimensional Echocardiogram / Color Flow Doppler

Right parasternal longitudinal view of the left ventricle (LV), left atrium (LA), and aorta (AO) in systole. Arrows indicate the anterior mitral valve leaflet and chordal structures partially obstructing the left ventricular outflow tract — systolic anterior motion (SAM) of the mitral valve.
Longitudinal view of the LV, LA, and AO in systole. Arrows mark the anterior mitral valve leaflet and chordal structures (SAM) partially obstructing the left ventricular outflow tract.
Color flow Doppler in the same longitudinal orientation as above. Two turbulent high-velocity jets originate from the same site in the left ventricular outflow tract during systole: one projects into the aorta (AO) and a second projects back into the left atrium (LA), consistent with SAM-related dynamic obstruction and secondary mitral regurgitation.
Color flow Doppler showing two turbulent jets originating from the LVOT obstruction site: one into the aorta (AO) and one back into the left atrium (LA).

When the color flow Doppler is used to look at blood flow in the same orientation as the view above, two high-velocity jets can be identified originating from the same site in the left ventricle (LV) during systole. One jet projects into the aorta (AO) and the other projects into (and curls around within) the left atrium (LA). Both originate from the site of obstruction seen in the echocardiogram above.


Video clips of echocardiograms from another cat with the same disease

Within this continuous loop of one cardiac cycle you can see the septal (anterior) mitral valve leaflet and chordal structures appear in the left ventricular outflow tract during systole. A portion of the cranial papillary muscle can be seen pulling chordae tendineae into the outflow tract.

Two turbulent jets can be seen — one projecting back into the left atrium and the other going out into the aorta. Both jets originate from the region in the outflow tract where the chordal structures and anterior mitral valve leaflet impinge on the outflow tract.


Quiz

1. These echocardiographic findings are consistent with what?

2. Which of the following drugs would not be indicated to treat the condition identified in question 1?