Figure 5. A: There was mild pressure gradient across the aortic valve suggestive of mild aortic stenosis. B: After isoproterenol, LV pressure at LV apex increased up to 180-200 mmHg while arterial pressure dropped down to 80 mmHg, resulting in 80-100mmHg intracavitary LV pressure gradient. Note that the arterial wave form showed double peaks consistent with bisferiens pulse due to intracavitary LV obstruction

From

Syncope Due to Intracavitary Left Ventricular Obstruction Secondary to Giant Esophageal Hiatus Hernia

Kazuhito Hirata, Yuji Shimabukuro, Takanori Takahashi, Minoru Wake

American Journal of Medical Case Reports. 2017, 5(4), 89-93 doi:10.12691/ajmcr-5-4-4