CASE: A case of secondary reversible LVOT obstruction
62 y/o male with a history of hypertension was admitted due to non-small cell lung cancer with stage IIIA.
- After neoadjuvant concurrent chemoradiation treatment, he underwent left lower lobectomy and mediastinal lymphadenectomy.
- On his 3rd postoperative day, he developed adult respiratory distress syndrome with shock and was transferred to ICU for mechanical ventilation.
- Patient was recurrently hypotensive despite vasopressors, and cardiology consultation was done.
- Pressure control mode on ventilator
- v/s: BP 100/80 mmHg, HR 130 RR 20 BT 38.3 °C
- CVP 4 to 5 cmH2O
- 3/6 systolic murmur at the left lower sternal border
- Basilar crackle at both lower lung
- ECG - NSR, LVH
- Cardiac enzymes - WNL
- Medication: Dobutamine 5mcg/kg/min, Dopamine 10mcg/kg/min
- Echocardiography was performed