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The mechanism of SAM is not completely understood. One hypothesis is that deformation of the mitral valve architecture (leaflets, chordae tendinae, papillary muscles) and the hyperdynamic state caused by myocardial hypertrophy cause SAM.
 
The mechanism of SAM is not completely understood. One hypothesis is that deformation of the mitral valve architecture (leaflets, chordae tendinae, papillary muscles) and the hyperdynamic state caused by myocardial hypertrophy cause SAM.
 
===Diastolic Dysfunction===
 
===Diastolic Dysfunction===
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Myocardial hypertrophy and interstitial fibrosis leads to reduced LV compliance. Tachycardia can exacerbate diastolic dysfunction by reducing diastolic time, and hence the time allowed for ventricular filling.  Since coronary blood flow to supply the myocardium occurs in diastole, tachycardia may accelerate myocardial ischaemia.  Diastolic dysfunction causes increased LV filling pressure. Left atrial (LA) enlargement initially compensates for this until maximal compliance of the atrium is reached. Once this point is reached, atrial pressure rises. This will subsequently result in pulmonary venous hypertension and eventually left-sided congestive heart failure. SAM and mitral regurgitation further contribute to ventricular filling pressure.
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===Systolic Dysfunction===
 
===Systolic Dysfunction===
  
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