Cardiac Arrest Due to Severe Dynamic Left Ventricular Outﬂow Obstruction and Hypertrophy Following Anesthesia Induction
1Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA
2Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA
3Department of Anesthesiology and Perioperative Medicine, Jacksonville, FL, USA
DOI: 10.22514/sv.2020.16.0071 Vol.16,Issue 2,October 2020 pp.207-209
Published: 28 October 2020
Cardiac arrest following induction of general anesthesia is a rare event. A 47-year-old woman with a history of chronic neck pain secondary to spinal stenosis presented for elective cervical laminectomy. Induction of general anesthesia induced cardiac arrest and emergency insertion of the transesophageal echocardiogram probe identified severe, undiagnosed left ventricular hypertrophy with dynamic outflow obstruction. Resuscitative treatment was immediately implemented to include aggressive intravenous fluid resuscitation, intravenous esmolol and phenylephrine to augment preload, afterload, and reflex bradycardia effect. Return of spontaneous circulation was achieved and the patient was admitted to the ICU, where she was extubated with preserved neurocognitive function on the same day. Our case describes the risk presented by undiagnosed cardiac abnormalities in what was accepted as a low-to-intermediate risk patient undergoing an elective procedure. The increasing popularity and use of pocket-sized handheld ultrasound devices may help reduce the risk of occurrences such as this in the future.
Cardiac arrest, Cardiomyopathy, Hypertrophic, Echocardiogram, Transesophageal
Michael F Harrison,Neil G Feinglass,Emir Festic. Cardiac Arrest Due to Severe Dynamic Left Ventricular Outﬂow Obstruction and Hypertrophy Following Anesthesia Induction. Signa Vitae. 2020. 16(2);207-209.
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