Jove
Visualize
Contact Us

Related Experiment Videos

Iatrogenic postoperative left ventricular outflow tract obstruction.

F K Nakhjavan, S Yazdanfar, V Bhasin

    Clinical Cardiology
    |May 1, 1983
    PubMed
    Summary

    Dobutamine hydrochloride can induce symptoms of hypertrophic subaortic stenosis in patients post-aortocoronary bypass graft surgery. These symptoms, including mitral regurgitation, resolved with fluid loading, highlighting the importance of hemodynamic management.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Prophylactic irradiation to the contralateral breast for BRCA mutation carriers with early-stage breast cancer.

    Annals of oncology : official journal of the European Society for Medical Oncology·2018
    Same author

    Resolving Macrophages Counter Osteolysis by Anabolic Actions on Bone Cells.

    Journal of dental research·2018
    Same author

    Letter: lipid-lowering effect of tenofovir disoproxil fumarate in chronic hepatitis B-more evidence is needed. Authors' reply.

    Alimentary pharmacology & therapeutics·2017
    Same author

    Tenofovir disoproxil fumarate significantly decreases serum lipoprotein levels compared with entecavir nucleos(t)ide analogue therapy in chronic hepatitis B carriers.

    Alimentary pharmacology & therapeutics·2017
    Same author

    Chemotherapy may eradicate ductal carcinoma in situ (DCIS) but not the associated microcalcifications.

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·2017
    Same author

    A case of tuberculosis in a pregnant woman and review of current literature.

    Obstetric medicine·2016
    JoVE
    x logofacebook logolinkedin logoyoutube logo
    ABOUT JoVE
    OverviewLeadershipBlogJoVE Help Center
    AUTHORS
    Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
    LIBRARIANS
    TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
    RESEARCH
    JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
    EDUCATION
    JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
    Terms & Conditions of Use
    Privacy Policy
    Policies

    Area of Science:

    • Cardiology
    • Cardiovascular Surgery
    • Pharmacology

    Background:

    • Postoperative hypotension following aortocoronary bypass graft (ACBG) surgery is a critical concern.
    • Management strategies often involve inotropic agents and hemodynamic support.
    • Hypertrophic subaortic stenosis (HSS) is a dynamic obstruction that can be influenced by ventricular loading conditions.

    Observation:

    • A 56-year-old female developed a harsh systolic murmur, mitral regurgitation, and intraventricular systolic pressure gradient after ACBG surgery.
    • These findings were suggestive of hypertrophic subaortic stenosis.
    • The patient received dobutamine hydrochloride for hypotension, combined with intra-aortic balloon pumping for afterload reduction.

    Findings:

    • The observed signs and symptoms of HSS were directly linked to dobutamine administration in the context of reduced afterload.

    Related Experiment Videos

  • Left ventriculography, which acts as a volume load, led to the immediate disappearance of the murmur and pressure gradient.
  • This indicates a reversible, drug-induced dynamic subaortic obstruction.

    • Implications:

    • Dobutamine hydrochloride, while effective for hypotension, can unmask or exacerbate dynamic subaortic stenosis in susceptible patients.
    • Careful hemodynamic monitoring and consideration of volume status are crucial when administering inotropic agents post-cardiac surgery.
    • Understanding the dynamic nature of HSS is vital for accurate diagnosis and management in the perioperative setting.