Key result
Stopping inotropes and removing IABP resolves dynamic LVOTO and hypotension in inferior MI.
Case Report (n=1)
IABP insertion in the setting of inferior STEMI and cardiogenic shock can precipitate or worsen dynamic LVOTO, which improves upon timely removal of the IABP and inotropes.
May guide inotrope and IABP management of dynamic LVOTO in inferior MI; hypothesis-generating single case leaves broader applicability open.
We present a complex case of a 50-year-old man who presented with inferior ST-elevation myocardial infarction and cardiogenic shock. Our patient presented with out-of-hospital ventricular fibrillation cardiac arrest. Cardiopulmonary resuscitation was promptly started and return of spontaneous circulation was achieved. The patient underwent urgent coronary angiography with implantation of drug-eluting stent in his right coronary artery. Intra-aortic balloon pump was inserted.
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Ng Ke Xuan Jessica (2021) conducted a case report in Cardiogenic shock and dynamic left ventricular outflow tract obstruction following inferior ST-elevation myocardial infarction (n=1). Intra-aortic balloon pump (IABP) was evaluated. Withdrawal of inotropes and timely removal of the intra-aortic balloon pump markedly improved hypotension and resolved dynamic left ventricular outflow tract obstruction in a patient with inferior myocardial infarction.
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