Dynamic LV outflow tract causes an inversion of all hemodynamics. Diuresis and inotropes may cause cardiogenic pulmonary edema! Vasoconstrictors and beta-blockers may improve cardiogenic pulmonary edema! Down is up and up is down. As you might imagine, failure to recognize this physiology could easily lead to management strategies that make matters worse.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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hey Josh. excellent as always. let’s see…I’m in a rural busy community hospital. (merced,ca)… I have a septic shock patient. I give sepsis fluids and norepinephrine. but they continue to worsen. I suspect that might be do to a variety of possibilities. But I guess the point is, if that is occurring, then think LVOTO. just not sure if my sono skills can discern this or LVOTO from one of the numerous other potential etiologies. the treatment is radically different, results depending on the discernment of LVOTO. I guess I just need to get much better with my sono. thank… Read more »