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HYPERTROPHIC CARDIOMYOPATHY ASSOCIATED WITH LEFT VENTRICULAR OUTFLOW TRACT…
HYPERTROPHIC CARDIOMYOPATHY ASSOCIATED WITH LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION
NITROGLYCERIN
REDUCES PRELOAD
REDUCES SYSTOLIC LV volume
WOULD BE BAD CAUSE IT CASUES NARROWING
esmolol
increases systolic LV volume
reduces contractility
phenylephrine
increases aortic pressure
increases transmural pressure
3 DETERMINAANTS OF BLOOD FLOW THROUGH LVOT
1. SYSTOLIC LV VOLUME
want to increase systolic volume
increase preload
or decrease HR
2. FORCE OF LV CONTRACTION
WANT TO DECREASE CONTRACTILITY
3. TRANSMURAL PRESSURE
WAN T TO INCREASE Ao PRESSURE.
PRESSURE DISTENDS THE LVOT
avoid
NARROWING
BOLUS OF 500ML NORMAL SALINE
OPPOSITE EFFECT OF NITROGLYCERIN THEREFORE DISTENDS IT
systolic anterior motion (sam)
occurs following mitral valve repair not replacement
diagnosed with TEE
ALSO CALLED
OBSTRUCTIVE HYPERTROPHIC CADRIOMYOPATHY (OHCM)
HPERTROPHIC OBSTRUCIVE CARDIOMYOPATHY (HOCM)
ASYMMETRIC SEPTAL HYPERTROPHY (ASH)
IDIOPATHIC HYPERTROPHIC SUBARTIC STENOSIS (IHSS)