Acquired dynamic left ventricular outflow tract obstruction complicating acute anterior myocardial infarction: Serial echocardiographic and clinical evaluation

Left Ventricular Outflow Tract Obstruction Provoked by Catecholamine in Acute Myocardial Infarction: Mechanistic Insights From An Animal Experiment

“…This is consistent with the clinical observation that patients with anterior AMI may occasionally develop significant LVOT obstruc- tion, especially during catecholamine infusion [1][2][3][4][5]. The significant relationship between reduced mitral annular size and the provoked LVOT obstruction by dobutamine infusion in the presence of anterior AMI is also consistent with the previous observation that excessive mitral leaflets beyond coaptation is the critical factor to cause LVOT obstruction or SAM in patients with hypertrophic cardiomyopathy [7][8][9][10][11].…”

“…This study further demonstrated that reduced anteroposterior dimension of the mitral annulus with augmented basal posterior LV contraction is related to the provoked LVOT obstruction by dobutamine infusion in the presence of anterior AMI. Utility LVOT obstruction following catecholamine infusion in anteroseptal AMI causes serious hemodynamic deterioration [1][2][3][4][5]. This study has demonstrated a potential relation between the provoked LVOT obstruction and reduced antero-posterior mitral annular dimension with hyperdynamic basal posterior LV wall.…”

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IntroductionSerious hemodynamic deterioration by left ventricular outflow tract (LVOT) obstruction following catecholamine infusion in anteroseptal acute myocardial infarction (AMI) has been reported [1][2][3][4][5]. It has been reported that LVOT obstruction in hypertrophic obstructive cardiomyopathy (HOCM) is related to 1) excessive anterior mitral leaflets beyond coaptation due to anteriorly located papillary muscles and abnormally elongated leaflets [6][7][8][9][10][11][12], 2) excessive posterior mitral leaflets [13], 3) reduced chordal tension, and others.

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Different Effects of Propranolol, Phenylephrine, and Saline Volume Loading on Catecholamine-Induced Left Ventricular Outflow Tract Obstruction in Acute Coronary Syndrome

“…catecholamine infusion in patients with acute coronary syndrome (ACS), [1][2][3][4][5] thereby resulting in serious hemodynamic deterioration. Previous reports have demonstrated that administration of a β-adrenoceptor blocker 6) or an α-adrenergic stimulator, 7) and avoidance of hypovolemia 7) can reverse LVOT obstruction in patients with hypertrophic obstructive cardiomyopathy.…”

Dynamic Intraventricular Obstruction in Acute Myocardial Infarction With Administration of Cilostazol

“…Recently, there have been some reports of dynamic intraventricular obstruction in the setting of AMI that resulted in a systolic murmur. [1][2][3][4][5][6][7] Moreover, dynamic intraventricular obstruction could be associated with a catastrophic medical outcome. We report a case of transient dynamic intraventricular obstruction in AMI following administration of cilostazol.…”