CTICasesSystolic Anterior Motion (SAM) of the Mitral Valve without Hypertrophic Cardiomyopathy
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Imaging findings
Echocardiography shows anterior motion of the mitral valve's anterior leaflet during systole, which partially obscures the aortic outflow jet. A late mitral regurgitation jet is also observed back into the left atrium as the valve leaflet moves forward, creating an incompetent valve.
Key takeaways
Systolic anterior motion (SAM) of the mitral valve is typically associated with hypertrophic cardiomyopathy and subaortic stenosis due to a Venturi phenomenon. However, SAM can occur in other settings with otherwise normal hearts, including hypertension, myocardial infarction, and even general anesthesia. The mechanism can involve changes in contractility of the papillary muscles, not just flow dynamics in a hypertrophied ventricle. It's important to recognize that SAM is not always indicative of hypertrophic cardiomyopathy.
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