Document Detail


Pathophysiology of dynamic left ventricular outflow tract obstruction in a critically ill patient.
MedLine Citation:
PMID:  20553322     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
Stefano Caselli; Annamaria Martino; Igino Genuini; Daria Santini; Iacopo Carbone; Luciano Agati; Francesco Fedele
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  27     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E122-4     Citation Subset:  IM    
Copyright Information:
© 2010, Wiley Periodicals, Inc.
Affiliation:
Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Rome, Italy. stefano.caselli@uniroma1.it
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