Systolic anterior motion of the mitral valve-beyond hypertrophic cardiomyopathy

Although most notably linked with hypertrophic cardiomyopathy, SAM has become increasingly recognised in a wide variety of cardiac conditions and in otherwise healthy hearts. The mechanisms underlying the development of SAM are unclear but seem to vary in different clinical settings. Left ventricular geometry - in particular, cavity size and myocardial mass, and the effect of endogenous and exogenous catecholamines can play an important part in the pathogenesis of SAM. Diagnosis of the underlying cause should, as always, be based upon the full clinical assessment of history and examination, together with ECG findings and a full echocardiographic assessment.