Norepinephrine-associated left ventricular outflow tract obstruction and systolic anterior movement. Issue 12 (2nd December 2019)

• Record Type: Journal Article
• Authors: Mampuya, Warner Mbuila; Dumont, Jonathan; Lamontagne, Francois
• Is Part Of: BMJ case reports. Volume 12:Issue 12(2019)
• Publication Date: 2019-12-02
• Subjects: cardiovascular system -- contraindications and precautions -- drug therapy related to surgery -- adult intensive care -- unwanted effects / adverse reactions; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-225879
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : In the perioperative setting, norepinephrine is used to increase blood pressure, an effect mediated mostly via arterial and venous vasoconstriction. Thus, norepinephrine is, allegedly, less likely to cause or worsen left ventricular outflow tract obstruction (LVOTO) than other inotropes. We report a case of norepinephrine-associated dynamic LVOTO and systolic anterior movement in a predisposed patient. This report highlights that unrecognised dynamic LVOTO may worsen shock parameters in patients treated with norepinephrine who have underlying myocardial hypertrophy.