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]

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]

A negative filling defect was present in the LVOT on color Doppler (Figure 3B). [ommegaonline.org]

• Congestive Heart Failure

  METHODS: We studied 8 patients with a history of systemic hypertension (6 females and 2 males, mean age 69+/-6 years), affected by New York Heart Association (NYHA) class IV congestive heart failure notwithstanding conventional drug therapy with digoxin [ncbi.nlm.nih.gov]

  Valve replacement for aortic stenosis with severe congestive heart failure and pulmonary hypertension. J Heart Valve Dis 1996; 5:268–272 PubMed Google Scholar 6. Lanzarini L, Fontana A, Lucca E, et al. [link.springer.com]

  The cumulative 3-year incidence of all-cause death, cardiac death, hospitalization for congestive heart failure (CHF), and recurrent TC was 24.2%, 0.0%, 6.5%, and 12.2%, respectively. [jstage.jst.go.jp]

• Surgical Procedure

  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 [archive-ouverte.unige.ch]

  We hereby describe the perioperative management of three patients with Hypertrophic cardiomyopathy for different surgical procedures. [annals.in]

  Doerge H, Schmitto JD, Walther S, Schoendube FA (2004) Extended myectomy for hypertrophic obstructive cardiomyopathy after failure or contraindication of septal ablation or with combined surgical procedures. [link.springer.com]

  Procedures: septal myectomy, ethanol ablation, pacemaker, ICD Septal myectomy During this surgical procedure, the surgeon removes a small amount of the thickened septal wall to widen the outflow tract (the path the blood takes) from the left ventricle [163.178.103.176]

  […] typically the surgical procedure of choice. [slideplayer.com]

• Anemia

  Post procedure, patient continued to do well with no recurrent heart failure symptoms, and there was resolution of hemolytic anemia. [bmccardiovascdisord.biomedcentral.com]

  Other conditions include arrhythmias (abnormal heart rhythms), disease of the heart valves, aortic stenosis, structural or anatomical defects of the coronary arteries, severe anemia, hypertrophic obstructive cardiomyopathy, etc. [news-medical.net]

  We report two cases of dynamic LVOT obstruction, the first patient with hypertension, mitral valve prolapse, anemia with associated hypovolemia and the second patient with vomiting and hypovolemia. [jiaecho.org]

• Sepsis

  The dynamic LVOT obstruction may occur as a result of other conditions such as, aortic valve replacement for aortic stenosis, hypertensive hypertrophy, dehydration, sepsis, vasodilatation, acute myocardial infarction, and mitral valve repair; however, [kjim.org]

• Nausea

  An 11 year old boy with a low-grade fever, left lower quadrant tenderness, nausea, and anorexia for the past 2 days. C. [slideplayer.com]

  Case of takotsubo cardiomyopathy (TC) with LVOT obstruction in a previously healthy 77-year-old woman who presented with chest pain and nausea. At hospital admission, her blood pressure was 64/46 mmHg with a systolic ejection murmur. [jstage.jst.go.jp]

• Vomiting

  She had vomiting 8–10 episodes for the past 3 days. No history of chest pain, syncope, swelling of the legs, and loose stools. [jiaecho.org]

  A 40 year old female with moderate left upper quadrant pain, vomiting small amounts of yellow bile, and worsening symptoms over the past week. D. [slideplayer.com]

• Diarrhea

  A 35 year old male complaining of severe, intermittent cramps with three episodes of watery diarrhea, 2 hours after eating. B. An 11 year old boy with a low-grade fever, left lower quadrant tenderness, nausea, and anorexia for the past 2 days. C. [slideplayer.com]

• Heart Failure

  CONCLUSIONS: Sometimes, a distinction between several forms of heart failure is clinically impossible. [ncbi.nlm.nih.gov]

  failure or death from heart failure or stroke (relative risk, 2.7; P Table 2 ). [nejm.org]

  Incidence of cardiovascular death, severe heart failure, or AF was significantly higher in patients with obstruction ( Table 2 ).At 10-year follow-up, cumulative risk of cardiovascular death, severe heart failure, or AF were, respectively, 27%, 34%, and [onlinejacc.org]

• 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]

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]

Four-year recurrence rate and prognosis of the apical ballooning syndrome. J Am Coll Cardiol 2007; 50 : 448–452. 17. Singh K, Carson K, Shah R, Sawhney G, Singh B, Parsaik A, et al. [jstage.jst.go.jp]

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]

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]

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

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

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]

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]

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]

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]

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]

As such, subvalvular left ventricular outflow obstruction complicating valvular aortic stenosis is a potentially preventable cause of persistently high gradients that remains relatively frequently encountered after AVR. [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]