Preoperative evaluation of systolic murmur with point-of-care echocardiography before an elective thoracic surgery - A case report -
- Author:
Jaemoon LEE
1
;
Minki LEE
;
Sookyung LEE
;
Chung-Sik OH
;
Tae-Yop KIM
Author Information
- Publication Type:Case Report
- From:Anesthesia and Pain Medicine 2024;19(1):62-67
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Systolic murmur suggesting the association of aortic valve (AV) stenosis or obstructive pathology in the left ventricular outflow tract (LVOT) usually requires preoperative echocardiographic evaluation for elective surgery.Case: In a 63-year-old female patient undergoing elective thoracic surgery, the systolic murmur was auscultated on the right sternal border of the second intercostal space in the preoperative patient holding area. Point-of-care (POC) transthoracic echocardiography (TTE) demonstrated a systolic jet flow in the LVOT area. The peak systolic velocity of the continuous wave Doppler tracing, aligned to the LVOT and the AV, was approximately 1.5 m/s. The peak/mean pressure gradient was 11/6 mmHg for the AV and 9/5 mmHg for the LVOT. Anesthesia was induced under continuous TTE imaging. Intraoperative transesophageal echocardiography also confirmed the absence of any cardiac pathology.
Conclusions:POC echocardiography offered a thorough preoperative evaluation of an unexpectedly identified systolic murmur, avoiding a potential delay in the operation schedule for conventional preoperative echocardiographic evaluation.
