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HNOCM

added by Emmel

HNOCM
Comments
Posted By: diego (953 days ago)

JORG I WANNA CONGRATULATE WITH YOU NOT ONLY FOR THIS EDUCATIONAL VIDEO
BASED CASE BUT MAINLY FOR THE DIAGNOSTIC APPROACH TO THIS CASE . I
RARELY MEET IN MY BEDSIDE ACTIVITY CLINICIANS AND I MEAN ....NAMELY
CARDIOLOGISTS WHO ARE ABLE TO HANDLE IN A SUCH COMPREHENSIVE MANNER
CARDIOVASCULAR ISSUES IN ICU SETTING
THIS SHOULD BE NOT ONLY A
PLATFORM TO SHARE IMAGES BUT IN MY HUMBLE OPINION A PLATFORM WHERE W
SHOULD SHARE THOUGHTS AND OPINIONS BESIDE THE ECHOCARDIOGRAM STUDY PER
SE ... SO TO SPEAK
WELL DONE JORG , WAY TO GO AND KEEP ON THIS
WAY


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Emmel

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Added: 19-12-2011
Runtime: 0m 10s
Views: 4014
Comments: 1

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Description

about 60 y old patient was admitted to our icu with typical clinical afflictions of ACS. Condition after transaortale septal myectomy in the case of HOCM for years. Actually we saw a distinct LV-hypertrophy with midventricular gradient dependent on heart rate. In LVOT we could found a notable acceleration of flow but NO SAM or midsystolic closure of aortic valve. Under the therapy with volume and beta-blocker (esmolol) we could see a rapidly haemodynamic improvement. DON´T give that patient inotropics in cases of haemodynamic instability! What do you think about? Make it sense to implantate a DDD-pacemaker to reach an asynchronous stimulation of the heart (with asynchronous contraction behavour/ cycle of right and left ventricle) to moderate the ventricular gradients?


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