Dynamic left ventricular outflow obstruction during lumbar laminectomy as an unexpected cause of intraoperative hypotension.
We present a case of previously undiagnosed hypertrophic obstructive cardiomyopathy (HOCM) with left ventricular outflow obstruction in a woman anesthetized for lumbar hemilaminectomy and diskectomy. The treatment of her sudden unexplained hypotension was initially confounded by a diagnosis of compensated congestive heart failure and diuretic therapy. Swift intervention with transesophageal echocardiography revealed the tru pathology altering her intraoperative treatment and her subsequent chronic treatment for her heart condition.
Zvara
David A
DA
Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1009, USA.
Olympio
Michael A
MA
Frankland
Michael J
MJ
Wilson
John A
JA
D000368:Aged; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy / Q000209:etiology*; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007431:Intraoperative Complications / Q000188:drug therapy / Q000209:etiology*; D007796:Laminectomy; D019635:Neurosurgical Procedures; D009765:Obesity / Q000150:complications; D013131:Spine / Q000601:surgery*; D014694:Ventricular Outflow Obstruction / Q000150:complications*