Yonsei Medical Journal

Yonsei Univ College Medicine (연세대학교의과대학)
권호 표지
DOI QR코드

DOI QR Code

Paradoxical Heart Failure Precipitated by Profound Dehydration: Intraventricular Dynamic Obstruction and Significant Mitral Regurgitation in a Volume-Depleted Heart

  • Kim, Dongmin (Cardiology Division, Department of Internal Medicine, Dankook University College of Medicine) ;
  • Mun, Jeong-Beom (Presbyterian Medical Center) ;
  • Kim, Eun Young (Department of Radiology, Gachon University of Medicine and Science) ;
  • Moon, Jeonggeun (Division of Cardiology, Department of Internal Medicine, Gachon University of Medicine and Science)
  • Published : 2013.07.01
⟨ Previous Next ⟩

Abstract

Occurrence of dynamic left ventricular outflow tract (LVOT) obstruction is not infrequent in critically ill patients, and it is associated with potential danger. Here, we report a case of transient heart failure with hemodynamic deterioration paradoxically induced by extreme dehydration. This article describes clinical features of the patient and echocardiographic findings of dynamic LVOT obstruction and significant mitral regurgitation caused by systolic anterior motion of the mitral valve in a volume-depleted heart.

Keywords

References

  1. Haley JH, Sinak LJ, Tajik AJ, Ommen SR, Oh JK. Dynamic left ventricular outflow tract obstruction in acute coronary syndromes: an important cause of new systolic murmur and cardiogenic shock. Mayo Clin Proc 1999;74:901-6. https://doi.org/10.4065/74.9.901
  2. Aurigemma G, Battista S, Orsinelli D, Sweeney A, Pape L, Cuenoud H. Abnormal left ventricular intracavitary flow acceleration in patients undergoing aortic valve replacement for aortic stenosis. A marker for high postoperative morbidity and mortality. Circulation 1992;86:926-36. https://doi.org/10.1161/01.CIR.86.3.926
  3. Villareal RP, Achari A, Wilansky S, Wilson JM. Anteroapical stunning and left ventricular outflow tract obstruction. Mayo Clin Proc 2001;76:79-83. https://doi.org/10.4065/76.1.79
  4. Mingo S, Benedicto A, Jimenez MC, Perez MA, Montero M. Dynamic left ventricular outflow tract obstruction secondary to catecholamine excess in a normal ventricle. Int J Cardiol 2006;112:393-6. https://doi.org/10.1016/j.ijcard.2005.07.075
  5. Yang JH, Park SW, Yang JH, Cho SW, Kim HS, Choi KA, et al. Dynamic left ventricular outflow tract obstruction without basal septal hypertrophy, caused by catecholamine therapy and volume depletion. Korean J Intern Med 2008;23:106-9. https://doi.org/10.3904/kjim.2008.23.2.106
  6. Chockalingam A, Dorairajan S, Bhalla M, Dellsperger KC. Unexplained hypotension: the spectrum of dynamic left ventricular outflow tract obstruction in critical care settings. Crit Care Med 2009;37:729-34. https://doi.org/10.1097/CCM.0b013e3181958710
  7. Verbalis JG. Disorders of body water homeostasis. Best Pract Res Clin Endocrinol Metab 2003;17:471-503. https://doi.org/10.1016/S1521-690X(03)00049-6
  8. Topalian S, Ginsberg F, Parrillo JE. Cardiogenic shock. Crit Care Med 2008;36(1 Suppl):S66-74. https://doi.org/10.1097/01.CCM.0000296268.57993.90

Cited by

  1. Cardiogenic shock accompanied by dynamic left ventricular outflow tract obstruction and myocardial bridging after transient complete atrioventricular block mimicking ST-elevation myocardial infarction vol.6, pp.None, 2013, https://doi.org/10.1186/1756-0500-6-478
  2. The Unusual Suspect: Anemia-induced Systolic Anterior Motion of the Mitral Valve and Intraventricular Dynamic Obstruction in a Hyperdynamic Heart as Unexpected Causes of Exertional Dyspnea after Cardi vol.46, pp.6, 2013, https://doi.org/10.5090/kjtcs.2013.46.6.457
  3. Clinically integrated multi-organ point-of-care ultrasound for undifferentiated respiratory difficulty, chest pain, or shock: a critical analytic review vol.4, pp.1, 2016, https://doi.org/10.1186/s40560-016-0172-1
  4. A Novel Hygrotaxis Assay for Assessing Thirst Perception and Water Sensation in Drosophila vol.9, pp.3, 2019, https://doi.org/10.21769/bioprotoc.3154