Key result
Norepinephrine administration in a predisposed patient with underlying myocardial hypertrophy was associated with dynamic left ventricular outflow tract obstruction and worsened shock parameters.
Why the study?
Norepinephrine is allegedly less likely to cause or worsen dynamic left ventricular outflow tract obstruction than other inotropes, but its occurrence remains unrecognised.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Norepinephrine may cause unrecognized dynamic LVOTO and systolic anterior movement in predisposed patients with underlying myocardial hypertrophy, potentially worsening shock.
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.
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Mampuya et al. (2019) conducted a case report in Left ventricular outflow tract obstruction and systolic anterior movement (n=1). Norepinephrine was evaluated. Norepinephrine administration in a predisposed patient with underlying myocardial hypertrophy was associated with dynamic left ventricular outflow tract obstruction and worsened shock parameters.
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