Norepinephrine and Dobutamine-Induced Dynamic Left Ventricular Outflow Tract Obstruction Caused by Systolic Anterior Motion.
| Autor: | Hung TD; Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam., Ha PVT; Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam., Chien DV; Department of Acute Cardiac Care, 108 Central Military Hospital, Hanoi, Vietnam. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of medical cases [J Med Cases] 2024 May; Vol. 15 (4-5), pp. 67-71. Date of Electronic Publication: 2024 May 02. |
| DOI: | 10.14740/jmc4204 |
| Abstrakt: | This study presents a case of norepinephrine and dobutamine-induced dynamic left ventricular outflow tract obstruction (LVOTO) caused by systolic anterior motion (SAM) in a patient experiencing acute anterior myocardial infarction (MI). In a 76-year-old patient presenting with acute MI, intensive use of norepinephrine and dobutamine may lead to the development of dynamic LVOTO and SAM. The presence of hypotension and a new cardiac murmur may suggest a mechanical complication such as acute mitral regurgitation (MR) or ventricular septal rupture (VSR). The assessment of the left ventricular outflow tract (LVOT) using echocardiography plays a critical role in the diagnosis of SAM and its associated MR and dynamic LVOTO. The patient's condition was stabilized through the cessation of inotropes and the implementation of aggressive fluid resuscitation, resulting in improved hemodynamics. In conclusion, prompt identification of the underlying pathophysiological mechanisms is imperative for effectively managing this condition and preventing hemodynamic exacerbation. Competing Interests: The authors declare no conflict of interest. (Copyright 2024, Hung et al.) |
| Databáze: | MEDLINE |
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