Sam I Am

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TEEintraoppreopME3CV
Short case presentation
60 yo male with history of chest pain and SOB with a history of laryngeal cancer, s/p radical neck dissection with chemo and XRT, carotid stenosis (LICA 88-99%) that was stented one month ago. He is on Pavix, ASA, Lipitor, and Coreg. He has been off of the Plavix for one week. Cardiac Cath showed LAD 90%, D1 90%, Ramus 90% and a LVEF of 65%. The patient is schedule for a CABG.

Please review the loops and consider the following questions:

What did the TEE show?
Is there a Left Ventricular Outlet Obstruction?
Is there Systolic Anterior Motion (SAM) of the Mitral Valve?
What are the causes/mechanisms of Systolic Anterior Motion (SAM) of the Mitral Valve?
What is the cause/mechanism in this case of the Systolic Anterior Motion of the Mitral Valve?
What is your recommendation?