Focused Cardiac Ultrasound Identification of Dynamic Left Ventricular Outflow Tract Obstruction

Education| December 2023 Focused Cardiac Ultrasound Identification of Dynamic Left Ventricular Outflow Tract Obstruction Ethan Garrigan, M.D., Pharm.D.; Ethan Garrigan, M.D., Pharm.D. 1Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina. Search for other works by this author on: This Site PubMed Google Scholar Grace McCarthy, M.D.; Grace McCarthy, M.D. 2Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham Veterans Health Administration, Durham, North Carolina. Search for other works by this author on: This Site PubMed Google Scholar Russell J. Krom, M.D., Ph.D.; Russell J. Krom, M.D., Ph.D. 3Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina. Search for other works by this author on: This Site PubMed Google Scholar Yuriy S. Bronshteyn, M.D., F.A.S.E. Yuriy S. Bronshteyn, M.D., F.A.S.E. 4Yuriy S. Bronshteyn, M.D., F.A.S.E.; Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham Veterans Health Administration, Durham, North Carolina. https://orcid.org/0000-0002-9250-9490 Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (). Published online first on September 18, 2023. Address correspondence to Dr. Bronshteyn: Anesthesiology December 2023, Vol. 139, 858–859. https://doi.org/10.1097/ALN.0000000000004697 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Ethan Garrigan, Grace McCarthy, Russell J. Krom, Yuriy S. Bronshteyn; Focused Cardiac Ultrasound Identification of Dynamic Left Ventricular Outflow Tract Obstruction. Anesthesiology 2023; 139:858–859 doi: https://doi.org/10.1097/ALN.0000000000004697 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: echocardiography, left ventricular outflow obstruction Focused cardiac ultrasound can narrow the differential diagnosis of shock between four categories: hypovolemic, cardiogenic, vasoplegic, and obstructive. Among subcategories of obstructive shock, dynamic left ventricular outflow tract obstruction is of special relevance to anesthesiologists because it (1) can arise in structurally normal hearts under common perioperative conditions (i.e., hypovolemia, vasoplegia, tachycardia, and/or inotropic excess)1 ; (2) masquerades as cardiogenic shock by causing a constellation of hypotension, low cardiac output, and high filling pressures2 ; (3) requires ultrasound for diagnosis1–3 ; and (4) requires unique treatments to dilate or distend the left ventricular outflow tract that are diametrically opposite the treatments of cardiogenic shock.1–3 The focused cardiac ultrasound image in figure 1 (left) shows a normal parasternal long-axis view (Supplemental Digital Content 1, https://links.lww.com/ALN/D239): the open state of the aortic valve identifies systole during which the left ventricular outflow tract is... You do not currently have access to this content.