A 75-year-old female presented for left total hip reimplantation and suffered pulseless electrical activity arrest upon lateral positioning and administering vancomycin. Resuscitation was achieved according to Advanced Cardiac Life Support protocol. [ncbi.nlm.nih.gov]

Case presentation: We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral PVL after undergoing surgical aortic and mitral valve replacement (MVR). [arizona.pure.elsevier.com]

Clinical features: Neonates with critical valvar aortic stenosis (AS) present with low cardiac output and shock, requiring emergency treatment. [mhmedical.com]

• Intravenous Administration

  On cardiac catheterization, a left ventricular peak systolic outflow gradient of 50 mm Hg was noted; this decreased to 10 mm Hg following intravenous administration of 100 mg of cibenzoline. [ncbi.nlm.nih.gov]

• Heart Disease

  disease in pediatric and adult patients. [books.google.de]

  NIH: National Heart, Lung, and Blood Institute Atrial septal defect (Medical Encyclopedia) Bicuspid aortic valve (Medical Encyclopedia) Congenital heart defect corrective surgeries (Medical Encyclopedia) Congenital heart disease (Medical Encyclopedia) [icdlist.com]

• Systolic Murmur

  Four hours after thrombolysis she developed acute pulmonary oedema and a new systolic murmur. It was presumed she had acute mitral regurgitation secondary to a ruptured papillary muscle, ischaemic dysfunction or an acute ventricular septal defect. [ncbi.nlm.nih.gov]

  […] hypertenison post AVR known LVH or HOCM increasing inotropes no tamponade Examination late systolic murmur over the praecordium Investigations ECHO: -> small LV cavity -> normal systolic function and no RWMA -> AVR functioning well -> flow acceleration [lifeinthefastlane.com]

  A newly detected systolic murmur in the left lower sternal border may be noticed upon physical examination; however a definitive diagnosis would require an echocardiographic examination. [kjim.org]

  HOCM should be suspected if a harsh systolic murmur is noted in conjunction with left ventricular hypertrophy and deep, broad Q waves. Diagnosis can be confirmed by echocardiography. [openanesthesia.org]

  Outflow tract obstruction may cause a systolic murmur at the left sternal edge, radiating to the aortic and mitral areas. Most patients with left ventricular outflow murmurs also have mitral regurgitation. [patient.info]

• Heart Murmur

  Other forms of LVOTO are often asymptomatic and may be detected by the presence of a heart murmur or abnormalities on ECG. Chest pain, dyspnea, and palpitations occur with increased activity as the degree of obstruction worsens. [mhmedical.com]

  Cyanotic heart disease (Medical Encyclopedia) Dextrocardia (Medical Encyclopedia) Echocardiogram -- children (Medical Encyclopedia) Heart murmurs and other sounds (Medical Encyclopedia) Patent ductus arteriosus (Medical Encyclopedia) Ventricular septal [icdlist.com]

  Physical exam: Your doctor will listen to your heart and lungs. Patients with severe hypertrophic obstructive cardiomyopathy (HOCM, or outflow tract obstruction) may have a heart murmur. [163.178.103.176]

  noctural dyspnea Irregular heart rate, pulmonary crackles, S3, S4 Heart murmurs, sudden cardiac death! [slideplayer.com]

• S4 Gallop

  S4 gallop is common. Aortic coarctation Absent or mild brachial to femoral pulse delay. 0-1/6 paraspinal MSM may be present. Significantly decreased/absent and delayed femoral pulses. >2/6 paraspinal MSM or continuous murmur. [circ.ahajournals.org]

• Left Axis Deviation

  ECG: Findings also may include right or left axis deviation, conduction abnormalities, sinus bradycardia with ectopic atrial rhythm and atrial enlargement. Voltage criteria for LVH alone are nonspecific and are often seen in normal young adults. [patient.info]

  […] systolic impulse ( Table ). 10 The ECG may demonstrate evidence of left ventricular hypertrophy and QRS left axis deviation that is indistinguishable from the findings in severe valvar aortic stenosis. [circ.ahajournals.org]

Swift intervention with transesophageal echocardiography revealed the tru pathology altering her intraoperative treatment and her subsequent chronic treatment for her heart condition. [ncbi.nlm.nih.gov]

Following neoadjuvant concurrent chemoradiation treatment, the patient underwent left lower lobectomy and mediastinal lymphadencetomy. [kjim.org]

Limited data are available on the mechanisms of LVOTO, their treatment, and outcomes. [archive-ouverte.unige.ch]

The long-term prognosis is excellent. [ncbi.nlm.nih.gov]

Results LV obstruction and prognosis Of the 526 study patients, 141 (27%) had LV obstruction. [onlinejacc.org]

Untreated, this subset of patients has a poor prognosis, with one study reporting more than 50 percent to worsen symptomatically and 11 percent dying by four- year follow-up. [advances-in-medicine.net]

Patients who presented exercise-induced DLVOTO in our series had a good prognosis at mid-term, as no events were observed after a mean follow-up of one year. [revespcardiol.org]

Incidence of LVOTO related to the mechanism of the mitral insufficiency and to the etiology demonstrates a direct relation to preoperative mitral valve prolapse (posterior leaflet +/- anterior leaflet) of degenerative origin. [ncbi.nlm.nih.gov]

Keywords Adolescent — Cardiac Surgical Procedures — Child — Child, Preschool — Humans — Infant — Mitral Valve Insufficiency/complications/surgery — Reoperation — Retrospective Studies — Risk Factors — Treatment Outcome — Ventricular Outflow Obstruction/etiology [archive-ouverte.unige.ch]

LVOT obstruction can be managed medically or invasively with surgical or percutaneous methods depending on the etiology and severity. [bmccardiovascdisord.biomedcentral.com]

Choi, and Kim: Dynamic left ventricular outflow tract obstruction without basal septal hypertrophy, caused by catecholamine therapy and volume depletion Abstract Hypertrophic cardiomyopathy (HCM) with hypertrophy of the basal septum is the most common etiology [kjim.org]

Epidemiology Left ventricular outflow tract obstruction (LVOTO) occurs in 2.8 of 10,000 live births, accounting for 3 to 6 percent of congenital heart defects. [mhmedical.com]

He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]

Epidemiology HCM is the most common genetic cardiovascular disease. HCM is generally inherited as an autosomal dominant trait with variable penetrance and expressivity. A minority of cases reflect a sporadic, non-familial form of the disease. [patient.info]

Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. [nature.com]

Epidemiology of hypertrophic cardiomyopathy-related death: revisited in a large non-referral-based patient population. Circulation 2000 ;102: 858 - 864 31. Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ. [nejm.org]

The pathophysiology, treatment, and role of intraoperative echocardiography of dynamic left ventricular outflow tract obstruction are discussed. [ncbi.nlm.nih.gov]

Pathophysiology Obstruction at any level causes increased left ventricular systolic pressure and wall stress and consequent left ventricular hypertrophy. Left ventricular hypertrophy produces subendocardial ischemia and diastolic dysfunction. [mhmedical.com]

It is imperative, therefore, that the pathophysiologic processes involved in DLVOTO be fully understood in order to initiate safe and appropriate therapy in critically ill patients.Our presentation and discussion focus on a hypotensive critically ill [karger.com]

Stress (Takotsubo) cardiomyopathy: A novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med 2008; 5 : 22–29. 28. [jstage.jst.go.jp]

Thus, surgical techniques to reduce AML heights should be considered in patients with disproportionately large anterior leaflets in order to prevent SAM. Selection of size of the annuloplasty ring should take into consideration the height of the AML. [ncbi.nlm.nih.gov]

Antibiotic medications are prescribed to prevent bacterial endocarditis, a potentially life-threatening condition. [163.178.103.176]

Patients with multiple risk factors for sudden death benefit from implantable cardioverter defibrillator (ICD) implantation for primary prevention. [patient.info]

[…] exam CURRENT PHARMACY TABLES that highlight indications, toxic effects, and drug interactions sections that present TYPICAL INDICATION CLINICAL SCENARIOS EXTENSIVELY EDITED CHAPTERS on cardiology, pulmonology, nephrology, critical care, geriatrics, preventive [books.google.de]

Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. European Heart Journal 2005;26:516-524. 3. Fernández A, Casabé H, Coronel R et al. [echobasics.de]