Focused Cardiac Ultrasound Identification of Dynamic Left Ventricular Outflow Tract 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
Source: Anesthesiology - Category: Anesthesiology Source Type: research