{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T23:30:03Z","timestamp":1726443003262},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Charit\u00e9"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In cases of hypertrophic obstructive cardiomyopathy (HOCM), the systolic anterior motion of the mitral valve apparatus results in an obstruction of the left ventricular outflow tract (LVOT), which is known as the SAM [systolic anterior motion] phenomenon. Hypothetically, a pathological obstruction of the LVOT of a different etiology would result in a comparable hemodynamic instability, which would be refractory to inotrope therapy, and may be detectable through echocardiography.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We observed a severely impaired left ventricular function due to a combination of a thrombotic LVOT obstruction and distinctive mitral regurgitation in a 56-year-old Caucasian, female patient after massive transfusion with aggressive procoagulant therapy. Initially, the patient had to be resuscitated due to cardiac arrest after a long-distance flight. The resuscitation attempts in combination with lysis therapy due to suspected pulmonary artery embolism were initially successful but resulted in traumatic liver injury, hemorrhagic shock and subsequent acute respiratory distress syndrome (ARDS). Oxygenation was stabilized with veno-venous extracorporeal membrane oxygenation (ECMO), but the hemodynamic situation deteriorated further. Transesophageal echocardiography (TEE) showed a massive, dynamic LVOT obstruction. Two thrombi were attached to the anterior leaflet of the mitral valve, resulting in a predominantly systolic obstruction. Unfortunately, the patient died of multiple-organ failure despite another round of lysis therapy and escalation of the ECMO circuit to a veno-venoarterial cannulation for hemodynamic support.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Massive transfusion with aggressive procoagulant therapy resulted in mitral valve leaflet thrombosis with dynamic, predominantly systolic LVOT obstruction, comparable to the SAM phenomenon. The pathology was only detectable with a TEE investigation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02840-3","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T23:05:23Z","timestamp":1621292723000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dynamic thromboembolic left ventricular outflow tract obstruction after aggressive procoagulant treatment in hemorrhagic shock: a case report"],"prefix":"10.1186","volume":"15","author":[{"given":"Vladimir","family":"Skrypnikov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Rosenthal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Weber-Carstens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Menk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Russ","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"issue":"3","key":"2840_CR1","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1097\/MCC.0000000000000304","volume":"22","author":"M Slama","year":"2016","unstructured":"Slama M, et al. Left ventricular outflow tract obstruction in ICU patients. Curr Opin Crit Care. 2016;22(3):260\u20136. https:\/\/doi.org\/10.1097\/MCC.0000000000000304.","journal-title":"Curr Opin Crit Care"},{"issue":"4","key":"2840_CR2","doi-asserted-by":"publisher","first-page":"W87","DOI":"10.1097\/RTI.0b013e31825412dd","volume":"27","author":"CM Walker","year":"2012","unstructured":"Walker CM, Reddy GP, Mohammed TL, et al. Systolic anterior motion of the mitral valve. J Thorac Imaging. 2012;27(4):W87.","journal-title":"J Thorac Imaging"},{"issue":"9","key":"2840_CR3","first-page":"E365","volume":"7","author":"S Kim","year":"2015","unstructured":"Kim S, Kim SJ, Kim J, et al. Dynamic obstruction induced by systolic anterior motion of the mitral valve in a volume-depleted left ventricle: an unexpected cause of acute heart failure in a patient with chronic obstructive pulmonary disease. 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J Cardiothorac Vasc Anesth. 2015;29(1):149\u201350.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"59","key":"2840_CR8","doi-asserted-by":"publisher","first-page":"421","DOI":"10.15557\/JoU.2014.0044","volume":"14","author":"D Sobczyk","year":"2014","unstructured":"Sobczyk D. Dynamic left ventricular outflow tract obstruction: underestimated cause of hypotension and hemodynamic instability. J Ultrason. 2014;14(59):421.","journal-title":"J Ultrason"},{"issue":"5","key":"2840_CR9","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1097\/HCO.0000000000000199","volume":"30","author":"BA Popescu","year":"2015","unstructured":"Popescu BA, Rosca M, Schwammenthal E. Dynamic obstruction in hypertrophic cardiomyopathy. Curr Opin Cardiol. 2015;30(5):468\u201374.","journal-title":"Curr Opin Cardiol"},{"issue":"4","key":"2840_CR10","doi-asserted-by":"publisher","first-page":"R147","DOI":"10.1186\/cc13982","volume":"18","author":"H Sch\u00f6chl","year":"2014","unstructured":"Sch\u00f6chl H, et al. Endogenous thrombin potential following hemostatic therapy with 4-factor prothrombin complex concentrate: a 7-day observational study of trauma patients. Crit Care. 2014;18(4):R147. https:\/\/doi.org\/10.1186\/cc13982 (Published 2014 Jul 9).","journal-title":"Crit Care"},{"issue":"10","key":"2840_CR11","doi-asserted-by":"publisher","first-page":"E122","DOI":"10.1111\/j.1540-8175.2010.01210.x","volume":"27","author":"S Caselli","year":"2010","unstructured":"Caselli S, Martino A, Genuini I, et al. Pathophysiology of dynamic left ventricular outflow tract obstruction in a critically ill patient. Echocardiography. 2010;27(10):E122\u20134.","journal-title":"Echocardiography"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02840-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-021-02840-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02840-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T23:34:10Z","timestamp":1621294450000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-02840-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2840"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-02840-3","relation":{},"ISSN":["1752-1947"],"issn-type":[{"type":"electronic","value":"1752-1947"}],"subject":[],"published":{"date-parts":[[2021,5,18]]},"assertion":[{"value":"1 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the legal guardian\u00a0of the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests.The results presented in this manuscript have not been published before.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"269"}}