| Pathophysiology of dynamic left ventricular outflow tract obstruction in a critically ill patient. | |
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MedLine Citation:
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PMID: 20553322 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Left ventricular outflow tract obstruction is not a rare problem in the intensive care units and can precipitate hemodynamic shock unresponsive to catecholamine therapy. The use of echocardiographic examination is extremely important in recognizing this phenomenon and its underlying conditions, finally identifying the most appropriate therapeutic strategy. The simple correction of one or more of these factors can dramatically change patients clinical outcome. We report the clinical case of a 72-year-old man who developed hemodynamic shock in the intensive care unit. Hypovolemia, catecholamine infusion, and mechanical ventilation induced geometric modification of the left ventricle causing a systolic anterior motion of the mitral anterior leaflet and a severe subaortic gradient. Simple restoration of fluids and discontinuation of medical therapy dramatically changed the outcome of the patient. A review of the medical literature has been carried out to deeply investigate pathophysiology of left ventricular outflow tract obstruction in critically ill patients. |
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Authors:
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Stefano Caselli; Annamaria Martino; Igino Genuini; Daria Santini; Iacopo Carbone; Luciano Agati; Francesco Fedele |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Echocardiography (Mount Kisco, N.Y.) Volume: 27 ISSN: 1540-8175 ISO Abbreviation: Echocardiography Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8511187 Medline TA: Echocardiography Country: United States |
Other Details:
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Languages: eng Pagination: E122-4 Citation Subset: IM |
Copyright Information:
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© 2010, Wiley Periodicals, Inc. |
Affiliation:
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Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Rome, Italy. stefano.caselli@uniroma1.it |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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