Dynamic left ventricular outflow tract obstruction precipitated during dobutamine stress echocardiography – normal variant or a true clinical dilemma? Review article

Article Sidebar

Requires Subscription PDF (Język Polski)


Published: Jun 30, 2009
Keywords:
LVOT obstruction, dobutamine stress echocardiography

Main Article Content

Marcin Szulc
Klinika Chorób Wewnętrznych, Nadciśnienia Tętniczego i Angiologii, Warszawski Uniwersytet Medyczny
Grzegorz Styczyński
Klinika Chorób Wewnętrznych, Nadciśnienia Tętniczego i Angiologii, Warszawski Uniwersytet Medyczny

Abstract

We presented a case of severe left ventricular outflow tract obstruction, caused by dobutamine infusion during a stress echocardiography with coexisting fall of blood pressure and angina. LVOT obstruction is usually linked to hypertrophic cardiomyopathy, but it is not unusual in other form of left ventricular hypertrophy. The special situation which may precipitate LVOT obstruction is dobutamine stress echocardiography. Subsequently we discuss the clinical significance of that finding.

Downloads

Download data is not yet available.

Article Details

How to Cite
Szulc , M., & Styczyński , G. (2009). Dynamic left ventricular outflow tract obstruction precipitated during dobutamine stress echocardiography – normal variant or a true clinical dilemma?. Cardiology in Practice, 3(2), 48-52. Retrieved from https://journalsmededu.pl/index.php/kwp/article/view/1657
Issue
Vol 3 No 2 (2009)
Section
Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

References

1. Maron B.J., McKenna W.J., Danielson G.K., Kappenberger L.J., Kuhn H.J., Seidman C.E., Shah P.M., Spencer W.H., Spirito P., Ten Cate F.J., Wigle E.D.: Hypertrophic Cardiomyopathy (Clinical Expert Consensus Document on). Eur. Heart J. 2003; 24: 1965-1991.
2. Mookadam F., Haley J.H., Olson L.J., Cikes M., Mookadam M.: Dynamic left ventricular outflow tract obstruction in senile cardiac amyloidosis. Eur. J. Echocardiogr. 2006; 7: 465-8.
3. Auer J., Berent R., Weber T., Lamm G., Eber B.: Catecholamine therapy inducing dynamic left ventricular outflow tract obstruction. Int. J. Cardiol. 2005; 101: 325-8.
4. Chockalingam A., Tejwani L., Aggarwal K., Dellsperger K.C.: Dynamic Left Ventricular Outflow Tract Obstruction in Acute Myocardial Infarction With Shock: Cause, Effect, and Coincidence. Circulation 2007; 116: 110-113.
5. Villareal R.P., Achari A., Wilansky S., Wilson J.M.: Anteroapical stunning and left ventricular outflow tract obstruction. Mayo. Clin. Proc. 2001; 76: 79-83.
6. Merli E., Sutcliffe S., Gori M., Sutherland G.G.R.: Tako-Tsubo cardiomyopathy: New insights into the possible underlying pathophysiology. European J. Echocardiography 2006; 7: 53-61.
7. Pellikka P.A., Oh J.K., Bailey K.R., Nichols B.A., Monahan K.H., Tajik A.J.: Dynamic intraventricular obstruction during dobutamine stress echocardiography: a new observation. Circulation 1992; 86: 1429-1432.
8. Henein M.Y., O’Sullivan C., Sutton G.C., Gibson D.G., Coats A.J.: Stress-induced left ventricular outflow tract obstruction: a potential cause of dyspnea in the elderly. J. Am. Coll. Cardiol. 1997; 30: 1301-7.
9. Luria D., Klutstein M.W., Rosenmann D., Shaheen J., Sergey S., Tzivoni D.: Prevalence and significance of left ventricular outflow gradient during dobutamine echocardiography. Eur. Heart J. 1999; 20: 386-392.
10. Dawn B., Paliwal V.S., Raza S.T., Mastali K., Longaker R.A., Stoddard M.F.: Left ventricular outflow tract obstruction provoked during dobutamine stress echocardiography predicts future chest pain, syncope, and near syncope. Am. Heart J. 2005 May; 149: 908-16.
11. Cabrera-Bueno F.J., Gómez-Doblas J.J., Munoz-García A., García-Pinilla J.M., Navarro M.J., de Teresa-Galván E.: Effort angina, normal coronary angiogram, and dynamic left ventricular obstruction. J. Am. Soc. Echocardiogr. 2007; 20: 415-20.
12. Cabrera-Bueno F.J., Gómez-Doblas J.J., Garcia-Pinilla J.M., Montiel-Trujillo A., Jiménez-Navarro M., Martinez-Del-Valle D., Jiménez-Hoyuela J.M., de Teresa-Galván E.: Dobutamine stress echocardiography identifies patients with angina and dynamic left ventricular outflow obstruction in physiological exercise. Echocardiography 2009; 26: 272-80.