Bilqees Akhtar, Asif Hanif, Waseem Ahmed, Kashif Siddique, Sana Elahi, Sataish Elahi.
Sub Aortic membrane “a rare but real threat” 5 years experience at a tertiary care center.
J Cardiovascular Dis Jan ;13(1):5-9.

BACKGROUND: Sub aortic membrane is an unusual cause of sub aortic stenosis. Disease has male preponderance. Associated congenital cardiac defects are found in 25-50% of the cases. OBJECTIVES: To see pattern, determine associated congenital cardiac defects and establish clinical course among our local population with subaortic membrane. MATERIAL and METHODS: This prospective, observational hospital based study was conducted at Cardiology Department, Mayo Hospital, Lahore. The purpose of the study was explained and informed consent was obtained from each patient. After a thorough history, clinical examination and twelve lead ECG, TTE was done on all patients. TOE, CT angiography and cardiac catheterization were done in 4 patients due to inadequate information on TTE. Surgery was done in 8 patients. Follow up was done for 5 years by TTE. RESULTS: We studied consecutive 14 patients (10 females & 4 males). Overall mean age in years was 26.71±13.57. Breathlessness (n=10), palpitation (n=8), angina (n=6), syncope (n=3) and presyncope (n=2) were the chief symptoms. LV function and dimensions were preserved in all except 2 patients. Mean LVIDD and LVIDS were 49.92±13.55mm and 32.57±15.00mm respectively. Mean EF was 64.71%. Mean diastolic IVST and LVPWT were14.4±2.8mm and 13.35±2.4mm. Type 1 & 2 (n= 10 and 4) subaortic membrane were present among our patients. Mean gradient across LVOT was 74.04±42.78. Most common cardiac defects were PDA, Coarctation and AS. VSD, ASD, Parachute mitral valve and MVP were other associated defects. A total of 3 patients died one early acute renal failure (ARF) and 2 late due to infective endocarditis (n=1) and redo surgery(n=1). CONCLUSION:Our study showed that disease has different gender distribution with female preponderance in Asian population. Associated congenital cardiac defects are responsible for early symptoms in young patients. KEY WORDS: Sub aortic membrane, Sub aortic stenosis, congenital cardiac defects

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com