Left ventricular outflow tract (LVOT) obstruction with systolic anterior
motion (SAM) of
mitral valve is not only limited to
patients with
hypertrophic cardiomyopathy . A
diagnosis of
LVOT obstruction with SAM is important because conventional inotropic support may potentially aggravate
hemodynamic deterioration. We present a case of
LVOT obstruction with SAM in a
patient who underwent an emergent
surgery for
ascending aortic dissection with
pericardial effusion . The
patient showed refractory
hypotension after standard pharmacologic interventions during induction of
anesthesia .
Transesophageal echocardiography (TEE) revealed
LVOT obstruction with SAM and it was managed appropriately under the guidance of TEE. Intraoperative TEE can
play an important
role in
diagnosis and management of
LVOT obstruction with SAM caused by
pericardial effusion .