Focused cardiac echocardiography in beach-chair position surgery: A case study

The haemodynamic response to the beach-chair position may be affected by the presence of left ventricular hypertrophy where remodelling of cardiac chambers can potentially lead to left ventricular outflow tract obstruction. We present a case report of severe hypotension in the beach-chair position,...

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Published inAnaesthesia and intensive care Vol. 47; no. 4; pp. 385 - 388
Main Authors Soeding, Paul F, Steel, Amelia, Wong, James, Hoy, Gregory A
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.07.2019
Sage Publications Ltd
Subjects
Blood
Cardiac output
Case reports
Echocardiography
Examination
Family medical history
Geometry
Heart
Hypertension
Hypertrophy
Measurement
Patients
Surgery
Ultrasonic imaging
Sydney New South Wales Australia
Australia
intraoperative hypotension
Echocardiography
left ventricular hypertrophy
left ventricular outflow tract obstruction
beach-chair position
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Summary:The haemodynamic response to the beach-chair position may be affected by the presence of left ventricular hypertrophy where remodelling of cardiac chambers can potentially lead to left ventricular outflow tract obstruction. We present a case report of severe hypotension in the beach-chair position, where focused cardiac ultrasound identified left ventricular hypertrophy and geometric features that contributed to the hypotensive response. This case illustrates that focused cardiac ultrasound has the potential to alert the clinician preoperatively to left ventricular outflow tract obstruction susceptibility during surgery in the beach-chair position, and intraoperatively to direct management should sudden decreases in blood pressure occur.
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Anaesthesia and Intensive Care, Vol. 47, No. 4, Jul 2019: 385-388
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X19863067