In this co-hosted podcast, Josh and Adam discuss dynamic left ventricular outflow tract obstruction (LVOTO), focusing on subvalvular obstruction. They explain the physiology behind LVOTO, emphasizing how typical resuscitation methods can worsen the condition. The hosts cover various clinical situations where LVOTO can occur, including distributive shock, hypertrophic obstructive cardiomyopathy, Takotsubo cardiomyopathy and core pulmonology. They highlight the importance of recognizing LVOTO in patients who don't respond to standard therapies for cardiogenic pulmonary edema or shock, and discuss echocardiographic findings that can aid in diagnosis. The conversation also covers management strategies, such as stopping inotropes and afterload reducers, administering fluids, and using vasopressors like phenylephrine or vasopressin to maintain blood pressure. They also touch on the use of beta blockers as a last resort.
Sign in to continue reading, translating and more.
Continue
