Key result
Echo-guided transvenous pacing restores hemodynamic stability in a patient with hypertensive HOCM in cardiogenic shock.
Why the study?
Cardiogenic shock due to HoCM crisis presents a clinical challenge because vasopressors and inotropes compromise hemodynamics and afterload reduction worsens LVOT obstruction.
Does transvenous pacing guided by bedside echocardiography improve hemodynamic stability in a patient with hypertensive hypertrophic obstructive cardiomyopathy crisis?
Case Report (n=1)
Does transvenous pacing guided by bedside echocardiography improve hemodynamic stability in a patient with hypertensive hypertrophic obstructive cardiomyopathy crisis?
Transvenous pacing guided by bedside echocardiography may be an effective strategy to restore hemodynamic stability in patients presenting with hypertensive hypertrophic obstructive cardiomyopathy crisis.
Should not yet change practice in HOCM cardiogenic shock; leaves open role of echo-guided pacing.
Cardiogenic shock due to hypertrophic obstructive cardiomyopathy (HoCM) crisis presents a clinical challenge as pharmacologic vasopressor and/or inotropic support can compromise hemodynamics and acute afterload reduction worsens left ventricular outflow tract (LVOT) obstruction. Hypertensive hypertrophic obstructive cardiomyopathy (HHoCM) is an entity mostly affecting elderly hypertensive women and could present with a clinical phenotype similar to HoCM crisis. We present a case of an 81-year-old female patient with HHoCM complicated by severe mitral regurgitation, in cardiogenic shock, in whom hemodynamic stability was restored with transvenous pacing guided by bedside echocardiography to optimize rate, left ventricle (LV) filling time, and cardiac output.
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Spindel et al. (2021) conducted a case report in Hypertensive hypertrophic obstructive cardiomyopathy (HHoCM) in cardiogenic shock (n=1). Transvenous pacing guided by bedside echocardiography was evaluated on Hemodynamic stability. Transvenous pacing guided by bedside echocardiography successfully restored hemodynamic stability in an 81-year-old female with hypertensive hypertrophic obstructive cardiomyopathy in cardiogenic shock.
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