Cardiogenic Shock Secondary to Dynamic Left Ventricular Outflow Tract Obstruction and Apical Ballooning after Nonmitral Cardiovascular Surgery

<div>The postoperative echocardiogram performed during hemodynamic instability revealed a left ventricular outflow tract (LVOT) obstruction caused by systolic anterior movement of the mitral leaflet (SAM). (a) SAM leading to dynamic LVOT obstruction and the apical ballooning of the left ventricle. (b) A severe mitral regurgitation secondary to SAM. (c) Elevated pressure gradient across LVOT of 73 mmHg with typical dagger-shaped spectral Doppler. (d) High pressure gradient across the mitral valve in systole. The SAM and ballooning of the LV apex was seen on the apical three-chamber view (Supplement video 2).</div>

Case Reports in Critical Care

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Figure 2: Cardiogenic Shock Secondary to Dynamic Left Ventricular Outflow Tract Obstruction and Apical Ballooning after Nonmitral Cardiovascular Surgery 

Figure 2 | Cardiogenic Shock Secondary to Dynamic Left Ventricular Outflow Tract Obstruction and Apical Ballooning after Nonmitral Cardiovascular Surgery 