# Mid-Ventricular Obliteration Diagnosed by Bedside-Focused Echocardiography in the Emergency Department in a Patient With Syncope and Associated Hypertrophic Cardiomyopathy: A Case Report

## TL;DR

A 61-year-old woman with aortic valve disease was diagnosed with mid-ventricular obliteration using bedside echocardiography after fainting in the emergency department.

## Contribution

This case highlights the use of bedside echocardiography to identify mid-ventricular obliteration in an emergency setting.

## Key findings

- Focused echocardiography revealed mid-ventricular obliteration due to hypertrophic remodeling.
- Left ventricular underfilling and hyperdynamic performance were observed in the patient.
- Emergency physicians can use echocardiography to recognize and manage this condition.

## Abstract

Syncope is a common complaint encountered in emergency medicine practice with multiple potential etiologies to investigate. The utility of focused bedside echocardiography allows emergency physicians to diagnose acute cardiovascular causes in a time-sensitive fashion. In this case report, a 61-year-old female with mixed aortic valve disease presented to the emergency department after a syncopal episode. In addition to standard electrocardiogram and laboratory testing, investigation with focused echocardiography performed at the point of care revealed mid-ventricular obliteration due to hypertrophic myocardial remodeling, left ventricular underfilling, and hyperdynamic performance. Key echocardiographic findings that may assist emergency physicians in recognizing and managing this physiological entity were discussed.