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      Dynamic Left Ventricular Outflow Tract Obstruction in Critically III Patients: Role of Transesophageal Echocardiography in Therapeutic Decision Making

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          Abstract

          A paradoxic hypotensive response to resuscitative treatment may be the first clue to dynamic left ventricular outflow tract obstruction (DLVOTO) in critically ill patients. If unrecognized, routine interventions aimed at improving cardiac performance may actually result in hypotension and low cardiac output, thus putting patients at risk for adverse event. It is imperative, therefore, that the pathophysiologic processes involved in DLVOTO be fully understood in order to initiate safe and appropriate therapy in critically ill patients.Our presentation and discussion focus on a hypotensive critically ill patient with unrecognized DLVOTO until further evaluation with transesophageal echocardiogram (TEE). We recommend that early TEE be performed on critically ill patients with unexplained hypotension that is poorly responsive to conventional resuscitative measures.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1997
          1997
          19 November 2008
          : 88
          : 3
          : 292-295
          Affiliations
          Departments of aMedicine and bPharmacology, University of Tennessee, Memphis, Tenn., USA
          Article
          177345 Cardiology 1997;88:292–295
          10.1159/000177345
          9129852
          © 1997 S. Karger AG, Basel

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          Page count
          Pages: 4
          Categories
          Case Report

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