“…Although hypertrophic obstructive cardiomyopathy (HOCM) is the most common cause of LVOT obstruction, this condition can be precipitated by several other factors that are frequently encountered in the neurocritical setting, even in the absence of underlying structural cardiac abnormalities [13]. Potential causes of LVOT in this setting include, but are not limited to, aggressive management with catecholamine pressors, hypovolemia, previous mitral or aortic valve repair, or left ventricular hypertrophy [13][14][15][16]. Dobutamine stress echocardiography (DSE) is a frequently used modality that can diagnose the presence of LVOT obstruction and resulting hypotension [17][18][19][20][21][22].…”