Key result
Focused 2-dimensional echocardiography identified left ventricular outflow tract obstruction in 3 patients with cardiogenic shock mimics, leading to altered management and improved hemodynamics.
Why the study?
Left ventricular outflow tract obstruction is a common cardiogenic shock mimic, but its diagnosis can be missed during conventional management.
Does focused 2D echocardiography identify LVOTO in patients with cardiogenic shock mimicking poor response to conventional treatment?
Case Report (n=3)
Does focused 2D echocardiography identify LVOTO in patients with cardiogenic shock mimicking poor response to conventional treatment?
Focused 2D echocardiography is crucial for identifying LVOTO in patients presenting with cardiogenic shock mimics, allowing for appropriate and life-saving management changes.
Supports consideration of LVOTO in refractory post-MI CS; hypothesis-generating before routine focused echocardiography.
Left ventricular outflow tract obstruction (LVOTO) is a common cardiogenic shock (CS) mimic. We present 3 cases of patients presenting with CS following myocardial infarction, exhibiting a poor response to conventional treatment with inotropy and mechanical circulatory support. This triggered echocardiographic assessment by critical care physicians using focused 2-dimensional (2D) echocardiography. This timely assessment identified anterior mitral valve leaflet entrainment into the left ventricular outflow tract (LVOT), causing LVOTO as the underlying shock mechanism. Echocardiographic findings have led to significant changes in management. The patients underwent fluid administration, weaning from inotropy, and mechanical circulatory support explantation, leading to relief of LVOTO and improved hemodynamics. Critical care basic 2D echocardiography accreditations focus on myocardial function and pericardial effusions. Relevant societies administering these accreditations should consider adding LVOT assessment to enable timely diagnosis of this life-threatening CS mimic.
No takes yet. Share an insight, caveat, or question.
Harrington et al. (2023) conducted a case report in Left ventricular outflow tract obstruction mimicking cardiogenic shock (n=3). Focused 2-dimensional echocardiography was evaluated on Identification of LVOTO and change in management. Focused 2-dimensional echocardiography identified left ventricular outflow tract obstruction in 3 patients with cardiogenic shock mimics, leading to altered management and improved hemodynamics.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: