Left Ventricular Outflow Tract Obstruction
Left ventricular outflow tract obstruction is suggested by the history of a murmur since childhood and episodes of exertional symptoms, such as dyspnea, syncope and chest discomfort consistent with angina pectoris.
The patient's history also provides clues as to the etiology and severity. A congenital condition associated with a genetic disorder is suggested by the history of a murmur since childhood and a family history of sudden death. A severe condition is suggested by the presence of syncope, which occurs when cerebral perfusion is reduced by a sudden fall in blood pressure. The cause of this are multifactorial and include reflex mediated vasodilatation, other alterations in preload and afterload complicating outflow tract obstruction and arrhythmias.