Low Subvalvular Aortic and Pulmonic Stenosis Caused by Asymmetrical Hypertrophy and Derangement of Muscle Bundles of the Ventricular Wall

Abstract

Eight cases with low subvalvular aortic stenosis have been described. Two of them had also a narrowing with a pressure gradient in the right ventricle. The stenosis is caused by an asymmetrical hypertrophy and an abnormal course of the muscle bundles of the ventricles with a disturbance in the mode of contraction. The stenosis is more marked during late systole as seen from cardioangiography and pressure recordings. The murmur is therefore late systolic and its maximal intensity is heard over the apex or at left sternal border at the 4th left interspace. The electrocardiogram shows signs of left ventricular hypertrophy which are more marked than expected from the degree of stenosis.