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May 15, 1967

Idiopathic Hypertrophic Subaortic Stenosis and Bacterial Endocarditis

Author Affiliations

From the Department of Medicine, Brooke General Hospital, Fort Sam Houston, Texas.

JAMA. 1967;200(7):643-645. doi:10.1001/jama.1967.03120200121034

BROCK demonstrated in 1957 that muscular hypertrophy can obstruct the outflow tract of the left ventricle during systole.1 During the past decade, numerous reports have helped to clarify the symptoms, signs, and hemodynamic phenomena that characterize the idiopathic form of hypertrophic subaortic stenosis. Bacterial endocarditis has so rarely occurred in association with this entity that the following case is reported. Acute endocarditis developed in an otherwise normal aortic valve in a patient with idiopathic hypertrophic subaortic stenosis.

Report of a Case  A 34-year-old man was well until 1957 when he began experiencing exertional dyspnea and angina pectoris. In early 1958, a cardiac murmur was detected and an electrocardiogram showed QS deformity in V1-3 and left ventricular hypertrophy. Catheterization of the right side of the heart demonstrated normal findings, and the initial impression was arteriosclerotic heart disease and mitral insufficiency.In 1961, digitalis administration was begun because of increasing