Key result
Discontinuing IABP and inotropes improves cardiac index ~32% in a post-MI dynamic LVOTO case.
Case Report (n=1)
No
Dynamic LVOTO should be considered as a cause of refractory cardiogenic shock in acute myocardial infarction, as standard therapies like IABP and inotropes can paradoxically worsen hemodynamics.
May warrant caution with IABP and inotropes in post-MI dynamic LVOTO; leaves open need for prospective evaluation.
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Hotta et al. (2023) conducted a case report in Acute myocardial infarction with cardiogenic shock and dynamic LVOTO (n=1). Intra-aortic balloon pumping and inotropic therapy vs. Discontinuation of therapy was evaluated on Hemodynamic parameters (cardiac index, LVOTO pressure gradient). Discontinuation of intra-aortic balloon pumping and inotropic therapy in a patient with post-myocardial infarction dynamic LVOTO improved hemodynamics, increasing cardiac index from 1.9 to 2.5 L/min/m2.
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