Korean J Anesthesiol.  2013 Jan;64(1):73-76. 10.4097/kjae.2013.64.1.73.

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

• Park KS
• Kim H
• Jung YS
• Kim HJ
• Lee JM
• Hong DM
• Jeon Y
• Bahk JH

• KMID: 2236239
• DOI: http://doi.org/10.4097/kjae.2013.64.1.73

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.

Keyword

Ascending aortic dissection; Hypotension; LVOT obstruction; Pericardial effusion; Systolic anterior motion of mitral valve

MeSH Terms

Anesthesia
Cardiomyopathy, Hypertrophic
Echocardiography, Transesophageal
Hemodynamics
Humans
Hypotension
Mitral Valve
Pericardial Effusion