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Anesth Analg 2002;94:310-312
© 2002 International Anesthesia Research Society

CARDIOVASCULAR ANESTHESIA

An Intraoperative Diagnosis of Dynamic Left Ventricular Outflow Tract Obstruction Using Transesophageal Echocardiography Leads to the Treatment with Intravenous Disopyramide

Minako Ashidagawa, MD, Maria Ohara, MD, and Yasuhiro Koide, MD

Department of Anesthesiology, Yokohama City University School of Medicine, Yokohama, Japan

Address correspondence and reprint requests to Yasuhiro Koide, MD, Department of Anesthesiology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004 Japan. Address e-mail to hiro{at}med.yokohama-cu.ac.jp

Hypertrophic obstructive cardiomyopathy (HOCM) is an uncommon familial disorder, traditionally characterized by asymmetric septal hypertrophy and left ventricular outflow tract (LVOT) obstruction (1). It is now recognized that HOCM may also include those patients with secondary left ventricular hypertrophy (LVH) and dynamic LVOT obstruction. In particular, a syndrome with similar clinical and echocardiographic findings has been identified in elderly patients exhibiting concentric LVH with chronic hypertension, aortic stenosis, or sigmoid-shaped septum (2).

IMPLICATIONS: During surgery, dynamic left ventricular outflow obstruction (LVOT) can potentially occur frequently, but diagnosis may be less frequent. When circulatory disturbance occurs with suspicion of LVOT obstruction, transesophageal echocardiography can provide exact proof of diagnosis and basis for immediate treatment.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.