Inter-ventricular septum is generally in parallel alignment with Anterior aspect of root of aorta.
Have a look at this echo form a 65year old man
- Sigmoid shaped IVS can cause a unique LVOT profile .
- Present in elderly . The exact mechanism and mechanical and hemodynamic implications are not known .
- It can rarely cause dynamic LVOT obstruction.
- When these patients develop Infero posterior MI there could be further collapse of IVS into LVOT .
Relationship between Aortic angle , Hypertension, HCM
Many of the HCM patients may show similar features .When ASH is confined only to basal IVS. HCM should not be diagnosed instead it is often a defect of aorta /IVS alignment .
Abnormal aortic angle with that of IVS may make the IVS appear sigmoid.
If patients with abnormally angled aorta develop hypertension ASH and sigmoid septum is more pronounced .
IVS dragging by mass effect on aortic root is possible and Aortic regurgitation may ensue