In EP Lab Digest’s Clinical Images section, we ask physicians to present case reports using primarily only the images for description. If you have any interesting cases that you would like to submit to this section, please email us at “eplabdigest@aol.com”.

Figure 1. Severe left ventricular out flow tract obstruction due to asymmetrical thickness of septum (solid thin arrow). It also shows jet of mitral regurgitation during systole (interrupted thin arrow). Figure 2. An area of septal infarct (white area) post-transcatheter alcohol ablation.

Case Report.
       A 41-year-old Asian woman presented with symptoms of palpitations, shortness of breath and chest heaviness on exertion. Transthoracic echocardiogram revealed severe asymmetrical hypertrophy (posterior wall thickness of 2 cm) and a significant septal wall thickness measuring 3 cm. Mild to moderate mitral regurgitation with a peak outflow tract gradient of 56 mmHg and PA pressure was noted at 52 mmHg.
       The patient was treated with transcatheter alcohol septal ablation and later with AICD for primary prevention of ventricular tachycardia.