| Acquired left ventricular outflow tract obstruction and cardiogenic shock treated with beta-blockers. | |
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MedLine Citation:
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PMID: 19328398 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Beta-blockers are normally contraindicated in the treatment of cardiogenic shock. A 70-year-old lady presents with an acute coronary syndrome complicated by critical cardiogenic shock. Coronary angiography shows an ulcerated nonobstructing plaque in the left anterior descending artery. She fails to improve with standard treatment with inotrope and intraaortic balloon pump. Echocardiography revealed acquired left ventricular outflow tract (LVOT) obstruction and secondary mitral regurgitation. Treatment with intravenous beta-blockers produced both clinical and hemodynamic improvement as well as resolution of LVOT obstruction. Echocardiography is essential in defining the mechanism of cardiogenic shock in patients with acute coronary syndrome. Inotropic support exacerbates cardiogenic shock due to acquired LVOT obstruction that is best treated with beta-blockers. |
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Authors:
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Justin S W Taylor; Richard Purnell; Zaheer R Yousef |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 27 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-30 Completed Date: 2009-04-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 373.e1-373.e3 Citation Subset: IM |
Affiliation:
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University Hospital of Wales, Cardiff, United Kingdom. jswt@totalise.co.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use* Aged Electrocardiography Female Humans Propanolamines / therapeutic use* Shock, Cardiogenic / diagnosis, drug therapy*, etiology Ventricular Outflow Obstruction / diagnosis, drug therapy*, etiology |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Propanolamines; 84057-94-3/esmolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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