Asymmetric septal hypertrophy complicated by dynamic left ventricular obstruction after intra-aortic balloon counterpulsation placement in the setting of anterior myocardial infarction.
We report the case of a 74-year-old patient admitted for acute anterior myocardial infarction and treated by intravenous thrombolysis. Because of hemodynamic instability, an intra-aortic balloon pump (IABP) was inserted. However, the patient's systolic blood pressure deteriorated early after IABP placement. Echocardiography revealed a dynamic left ventricular outflow tract obstruction occurring only during assisted ventricular systoles. Interruption of counterpulsation allowed complete resolution of the dynamic obstruction and improvement of hemodynamic status.
Cohen
Rémy
R
Department of Cardiology, Centre Hospitalier Lagny-Marne-la-Vallée, France.
Rivagorda
Joel
J
Elhadad
Simon
S
D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D014694:Ventricular Outflow Obstruction / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology