Acquired left ventricular outflow tract obstruction and cardiogenic shock treated with β-blockers

Taylor, Justin S. W., Purnell, Richard and Yousef, Zaheer R. 2009. Acquired left ventricular outflow tract obstruction and cardiogenic shock treated with β-blockers. The American Journal of Emergency Medicine 27 (3) , 373.e1-373.e3. 10.1016/j.ajem.2008.07.023

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Abstract

β-Blockers are normally contraindicated in the treatment of cardiogenic shock. A 70-year-old lady presents with an acute coronary syndrome complicated by critical cardiogenic shock. Coronary angiography shows an ulcerated nonobstructing plaque in the left anterior descending artery. She fails to improve with standard treatment with inotrope and intraaortic balloon pump. Echocardiography revealed acquired left ventricular outflow tract (LVOT) obstruction and secondary mitral regurgitation. Treatment with intravenous β-blockers produced both clinical and hemodynamic improvement as well as resolution of LVOT obstruction. Echocardiography is essential in defining the mechanism of cardiogenic shock in patients with acute coronary syndrome. Inotropic support exacerbates cardiogenic shock due to acquired LVOT obstruction that is best treated with β-blockers.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General)
Publisher:	Elsevier
ISSN:	0735-6757
Last Modified:	05 Nov 2019 03:34
URI:	https://orca.cardiff.ac.uk/id/eprint/23644

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