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Epinephrine (adrenaline) preventing recovery from intraoperative anaphylactic shock complicated by systolic anterior motion of the mitral valve with left ventricular outflow tract obstruction on transoesophageal echocardiography
- Source :
- Anaesthesia and intensive care. 46(6)
- Publication Year :
- 2018
-
Abstract
- We describe a case of severe left ventricular outflow tract obstruction (LVOTO) with severe mitral incompetence due to systolic anterior motion of the anterior mitral leaflet (SAM) that was recognised thanks to the immediate availability of transoesophageal echocardiography during the resuscitation of anaphylactic shock. The patient rapidly responded to cessation of the epinephrine (adrenaline) infusion and intravascular volume expansion with intravenous crystalloid. The absence of risk factors for developing SAM/LVOTO serve as a warning to clinicians to consider this diagnosis in all cases of epinephrine non-responsive anaphylactic shock.
- Subjects :
- Male
Resuscitation
medicine.medical_specialty
Epinephrine
Ventricular outflow tract obstruction
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Transoesophageal echocardiography
Ventricular Outflow Obstruction
03 medical and health sciences
0302 clinical medicine
030202 anesthesiology
Internal medicine
Mitral valve
medicine
Intravascular volume status
Humans
Intraoperative Complications
Anaphylaxis
business.industry
Mitral Valve Insufficiency
Crystalloid Solutions
Middle Aged
medicine.disease
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Mitral incompetence
cardiovascular system
Cardiology
Mitral Valve
medicine.symptom
business
Adrenergic alpha-Agonists
Echocardiography, Transesophageal
medicine.drug
Subjects
Details
- ISSN :
- 0310057X
- Volume :
- 46
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Anaesthesia and intensive care
- Accession number :
- edsair.doi.dedup.....cc3bb7e4a8081cad27e14b59798726d9