Dynamic left ventricular outflow tract obstruction in the setting of acute anterior myocardial infarction: A serious and potentially fatal complication?

被引:19
作者
Hrovatin, E [1 ]
Piazza, R [1 ]
Pavan, D [1 ]
Mimo, R [1 ]
Macor, F [1 ]
Dall'Aglio, V [1 ]
Burelli, C [1 ]
Cassin, M [1 ]
Canterin, FA [1 ]
Brieda, M [1 ]
Vitrella, G [1 ]
Gilberto, C [1 ]
Nicolosi, GL [1 ]
机构
[1] AO SM Angeli, Unita Operat Cardiol, ARC, I-33100 Udine, Italy
来源
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES | 2002年 / 19卷 / 06期
关键词
echocardiography; acute myocardial infarction; outflow tract dynamic gradient;
D O I
10.1046/j.1540-8175.2002.00449.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Dynamic left ventricular outflow tract (LVOT) obstruction was thought to be a hallmark of hypertrophic obstructive cardiomyopathy, especially in those cases with isolated asymmetric septal hypertrophy and systolic anterior motion (SAM) of the mitral valve. Recently, several authors described the occurrence of a dynamic LVOT obstruction during acute coronary insufficiency in ventricles without significant myocardial hypertrophy. The LVOT gradient was reported to disappear following resolution of the ischemic syndrome. Furthermore, it was reported that LVOT obstruction in the setting of acute myocardial infarction could predispose to cardiac rupture. We describe four cases with acute anterior myocardial infarction complicated with a dynamic LVOT obstruction documented by transthoracic Doppler echocardiogram. The detection of the dynamic LVOT obstruction allowed us to optimize the pharmacological treatment in each case. In spite of therapy, two of our patients worsened progressively to fatal cardiogenic shock and cardiac rupture. In conclusion, the development of a LVOT obstruction during acute anterior myocardial infarction has to be considered a serious and potentially fatal complication.
引用
收藏
页码:449 / 455
页数:7
相关论文
共 16 条
[1]   Dynamic left ventricular outflow tract obstruction as a complication of acute myocardial infarction [J].
Armstrong, WF ;
Marcovitz, PA .
AMERICAN HEART JOURNAL, 1996, 131 (04) :827-830
[2]   DYNAMIC LEFT-VENTRICULAR OUTFLOW TRACT OBSTRUCTION AFTER ANTERIOR MYOCARDIAL-INFARCTION - A POTENTIAL MECHANISM OF MYOCARDIAL RUPTURE [J].
BARTUNEK, J ;
VANDERHEYDEN, M ;
DEBRUYNE, B .
EUROPEAN HEART JOURNAL, 1995, 16 (10) :1439-1442
[3]  
Chesi G, 1989, Minerva Cardioangiol, V37, P351
[4]  
DECONTI F, 1998, CARDIOVASC IMAG, V10, P65
[5]  
Di Chiara A, 2001, Ital Heart J, V2, P60
[6]   Transformation of mitral valve prolapse to dynamic left ventricular outflow tract obstruction and back again in a patient with acute transient myocardial depression [J].
Fisher, SD ;
Eichelberger, JP ;
Pomerantz, R ;
Delehanty, J .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2000, 13 (04) :319-321
[7]   Dynamic left ventricular outflow tract obstruction in acute coronary syndromes: An important cause of new systolic murmur and cardiogenic shock [J].
Haley, JH ;
Sinak, LJ ;
Tajik, AJ ;
Ommen, SR ;
Oh, JK .
MAYO CLINIC PROCEEDINGS, 1999, 74 (09) :901-906
[8]   Acquired dynamic left ventricular outflow tract obstruction complicating acute anterior myocardial infarction: serial echocardiographic and clinical evaluation [J].
Joffe, II ;
Riley, MF ;
Katz, SE ;
Ginsburg, GS ;
Douglas, PS .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 1997, 10 (07) :717-721
[9]  
Keegan MT, 2000, MAYO CLIN PROC, V75, P216
[10]   Left ventricular outflow tract obstruction after myocardial infarction due to a hyperdynamic basal septum [J].
Landesman, KA ;
Sadaniantz, A .
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2001, 18 (04) :291-294