Related Experiment Video

Updated: Jun 24, 2026

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

Acquired left ventricular outflow tract obstruction and cardiogenic shock treated with beta-blockers

Justin S W Taylor1, Richard Purnell, Zaheer R Yousef

  • 1University Hospital of Wales, Cardiff, United Kingdom. jswt@totalise.co.uk

The American Journal of Emergency Medicine
|March 31, 2009
PubMed

Insights

Beta-blockers, typically contraindicated in cardiogenic shock, effectively treated a patient with acute coronary syndrome. Intravenous beta-blockers resolved left ventricular outflow tract obstruction and improved hemodynamics.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Cardiogenic shock is a life-threatening condition often associated with acute coronary syndromes.
  • Beta-blockers are generally contraindicated in cardiogenic shock due to their negative inotropic effects.

Observation:

  • A 70-year-old female presented with acute coronary syndrome and critical cardiogenic shock.
  • Standard treatments including inotropes and intra-aortic balloon pump failed to improve her condition.
  • Echocardiography identified acquired left ventricular outflow tract (LVOT) obstruction and secondary mitral regurgitation.

Findings:

  • Intravenous beta-blocker administration led to significant clinical and hemodynamic improvement.
  • The beta-blocker treatment also resulted in the resolution of LVOT obstruction.
  • Echocardiography proved essential in diagnosing the specific mechanism of cardiogenic shock.

Implications:

  • Echocardiography is crucial for accurate diagnosis of cardiogenic shock mechanisms in acute coronary syndrome.
  • Inotropic agents can worsen cardiogenic shock when LVOT obstruction is present.
  • Beta-blockers represent a potential therapeutic option for cardiogenic shock caused by acquired LVOT obstruction.

More Related Videos

Implantation of Total Artificial Heart in Congenital Heart Disease07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat08:34

Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat

Published on: November 18, 2018

Related Concept Videos

Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...