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-.
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.
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Keun Suk
KS
Park
Hyerim
H
Kim
Yoo Sun
YS
Jung
Hyun Joo
HJ
Kim
Jung-Man
JM
Lee
Deok Man
DM
Hong
Yunseok
Y
Jeon
Jae-Hyon
JH
Bahk
Ascending aortic dissection; Hypotension; LVOT obstruction; Pericardial effusion; Systolic anterior motion of mitral valve