Diastolic Paradoxic Jet Flow of the Right Ventricle in Hypertrophic Cardiomyopathy

An early diastolic flow from the left ventricular apex to the base can be shown in patients with hypertrophic cardiomyopathy (HCM). This tiny flow or a diastolic paradoxic jet flow is important to detect on echocardiography because of its association with cardiovascular adverse events. We report an asymptomatic 44-year-old man with mid-ventricular obstructive HCM, in which a diastolic paradoxic jet flow was observed not only in the left ventricle but also in the right ventricle. The diastolic paradoxic jet flow in the right ventricle started approximately 110 ms after the onset of the second heart sound, lasted for almost 95 ms, and disappeared in coincidence with the third heart sound; the onset was later and the duration was similar, compared with the diastolic paradoxic jet flow in the left ventricle. He had been doing well without any medication for months and later lost to follow-up.