Auer J, Berent R, Weber T, Lamm G, Eber B
Int J Cardiol. 2005 May 25;101(2):325-8. doi: 10.1016/j.ijcard.2004.02.011.
Hypertrophic obstructive cardiomyopathy with significant hypertrophy of the basal septum is the most frequently reported cause of left ventricular outflow tract (LVOT) obstruction. Additionally, other conditions such as dehydration, sepsis, vasodilatation, or mitral valve repair have been associated with LVOT obstruction. In this report, we present a case of a patient without hypertrophy who developed severe dynamic left ventricular outflow tract obstruction during catecholamine stimulation for shock that complicated severe pancreatitis. The present case serves as a reminder that hypovolemia together with a hyperdynamic state resulting from catecholamine administration may result in the development of dynamic LVOT obstruction even if baseline cardiac evaluation is unremarkable. Early detection and intensive efforts to reverse the underlying conditions, including cessation of catecholamine therapy and correction of hypovolemia are essential.
伴有基底间隔显著肥厚的肥厚性梗阻性心肌病是最常报道的左心室流出道(LVOT)梗阻原因。此外,其他情况如脱水、脓毒症、血管扩张或二尖瓣修复也与LVOT梗阻有关。在本报告中,我们呈现了一例患者,该患者无心肌肥厚,在因重症胰腺炎并发休克而进行儿茶酚胺刺激时发生了严重的动态左心室流出道梗阻。本病例提醒我们,即使基线心脏评估无异常,低血容量以及儿茶酚胺给药导致的高动力状态也可能导致动态LVOT梗阻的发生。早期检测并积极努力纠正潜在状况,包括停止儿茶酚胺治疗和纠正低血容量至关重要。