{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:39:16Z","timestamp":1747190356014,"version":"3.40.5"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T00:00:00Z","timestamp":1606176000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2020,11,24]]},"abstract":"<jats:p>Background. The dynamic obstruction of the left ventricular outflow tract (LVOT) is a well-known complication in mitral annuloplasty but rarely seen in nonmitral cardiovascular surgery. The dynamic LVOT obstruction can lead to hemodynamic instability, even shock and the treatment is significantly different from the standard approach. Case Presentation. We reported a case of low cardiac output syndrome (LCOS) with severe mitral regurgitation (MR), dramatically reduced left ventricular ejection fraction (LVEF) after coronary artery bypass grafting in a 72-year-old female requiring an escalation of inotropic support, volume restriction, and mechanical support. The detailed echocardiography combined with lung ultrasound revealed a dynamic systolic anterior movement of the anterior mitral leaflet (SAM), apical ballooning, and no significant lung congestion. Intravenous fluids were given, diuretics withdrawn, inotrope discontinued, and vasopressors uptitrated. The dynamic SAM was rapidly relieved, the hemodynamics was stabilized, and the LVEF was improving. The patient was discharged in good condition without residual LVOT obstruction and trace MR. Conclusion. We strongly suggest that a detailed echocardiography should be performed in any patient who presents in shock to rule out a dynamic LVOT obstruction. Lung ultrasound should be a routine examination in addition to echocardiography. Once SAM is detected, treatment should be based on volume expansion, inotrope discontinuation, and a careful afterload increasing.<\/jats:p>","DOI":"10.1155\/2020\/8826187","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T01:05:08Z","timestamp":1606439108000},"page":"1-6","source":"Crossref","is-referenced-by-count":1,"title":["Cardiogenic Shock Secondary to Dynamic Left Ventricular Outflow Tract Obstruction and Apical Ballooning after Nonmitral Cardiovascular Surgery"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2973-7909","authenticated-orcid":true,"given":"Hoang Bac","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of General Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang Str., Ward 11, District 5, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6769-0849","authenticated-orcid":true,"given":"Hoang Dinh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang Str., Ward 11, District 5, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thi Thanh Thuy","family":"Tran","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang Str., Ward 11, District 5, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2250-0818","authenticated-orcid":true,"given":"Minh Khoi","family":"Le","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang Str., Ward 11, District 5, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezr232"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.10.087"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.5090\/kjtcs.2013.46.6.457"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1177\/1179546817751921"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0b013e3181cea0dd"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.09.024"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.4065\/74.9.901"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.02.001"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.01.084"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.107.756585"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.12.033"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.05.002"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2012.12.014"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.4103\/0971-9784.81561"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v6.i7.602"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2020\/8826187.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2020\/8826187.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2020\/8826187.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T01:05:10Z","timestamp":1606439110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/cricc\/2020\/8826187\/"}},"subtitle":[],"editor":[{"given":"Joel","family":"Starkopf","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,11,24]]},"references-count":15,"alternative-id":["8826187","8826187"],"URL":"https:\/\/doi.org\/10.1155\/2020\/8826187","relation":{},"ISSN":["2090-6439","2090-6420"],"issn-type":[{"type":"electronic","value":"2090-6439"},{"type":"print","value":"2090-6420"}],"subject":[],"published":{"date-parts":[[2020,11,24]]}}}