Left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve in patient with pericardial effusion caused by ascending aortic dissection: A case report.
10.4097/kjae.2013.64.1.73
- Author:
Keun Suk PARK
1
;
Hyerim KIM
;
Yoo Sun JUNG
;
Hyun Joo KIM
;
Jung Man LEE
;
Deok Man HONG
;
Yunseok JEON
;
Jae Hyon BAHK
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea. bahkjh@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Ascending aortic dissection;
Hypotension;
LVOT obstruction;
Pericardial effusion;
Systolic anterior motion of mitral valve
- MeSH:
Anesthesia;
Cardiomyopathy, Hypertrophic;
Echocardiography, Transesophageal;
Hemodynamics;
Humans;
Hypotension;
Mitral Valve;
Pericardial Effusion
- From:Korean Journal of Anesthesiology
2013;64(1):73-76
- CountryRepublic of Korea
- Language:English
-
Abstract:
Left ventricular outflow tract (LVOT) obstruction with systolic anterior motion (SAM) of mitral valve is not only limited to patients with hypertrophic cardiomyopathy. A diagnosis of LVOT obstruction with SAM is important because conventional inotropic support may potentially aggravate hemodynamic deterioration. We present a case of LVOT obstruction with SAM in a patient who underwent an emergent surgery for ascending aortic dissection with pericardial effusion. The patient showed refractory hypotension after standard pharmacologic interventions during induction of anesthesia. Transesophageal echocardiography (TEE) revealed LVOT obstruction with SAM and it was managed appropriately under the guidance of TEE. Intraoperative TEE can play an important role in diagnosis and management of LVOT obstruction with SAM caused by pericardial effusion.
