Acute valvular insufficiency complicating hypertrophic obstructive cardiomyopathy.

This report describes a patient with hypertrophic obstructive cardiomyopathy complicated by acute aortic and probably mitral valvular incompetence caused by endocarditis due to Staphylococcus aureus. Following the onset of valvular insufficiency, this patient developed hypotension and pulmonary edema and eventually underwent cardiac surgery in an attempt to control these complications. We review the unique pathophysiology of hypertrophic obstructive cardiomyopathy and its alterations in the presence of acute valvular incompetence and analyze the limitations of medical management of cardiac decompensation in patients with this combination of cardiac abnormalities. The possible need for early surgery in such patients is examined.