Intraarrest lvot - GrepMed

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LVOT Obstruction noted during CPR on TEE (iatrogenic LVOT obstruction)

- Dr. Tom Jelic
@TomJelic

#LVOT #Obstruction #CPR #ACLS

LVOT Obstruction ... TEE (iatrogenic LVOT ... @TomJelic #LVOT ... TransEsophageal #Intraarrest

Stroke Volume & Cardiac Output Measurement on POCUS
Accurately measure LVOT diameter:
1. Obtain PLAX
2. Zoom to

Accurately measure LVOT ... Zoom to LVOT 3. ... PW doppler into LVOT ... VTI x π (LVOT Diam ... /2) 2 SV = LVOT

POCUS - Measuring Cardiac Output
1) Calculate LVOT Area
2) Calculate LVOT VTI
3) Calculate Cardiac Output

SV = (LVOT

Area 2) Calculate LVOT ... Output SV = (LVOT ... Area) x (LVOT VTI ... ) CO = (LVOT Area ... ) x (LVOT VTI) X

LVOT measurement
1. PLX view zoom mode
2. Measure within 5 mm to 10 mm from aortic annulus

LVOT measurement ... Mid-systole #LVOT

LVOTO due to SAM on POCUS Echocardiogram

Septic patient after IV fluids and initiation of Levophed. Worsening

LVOTO due to SAM ... Answer: Dynamic LVOTO ... Anterior #Motion #LVOTO

PLAX. Bit Las Vegas gains posteriorly 😉 lovely HOCM case with systolic anterior motion. Significant LVOT

Significant LVOT

The Role of Echocardiography in Hypertrophic Cardiomyopathy
• Establish diagnosis & determine pattern of hypertrophy
•

& severity of LVOT

Apical 5-Chamber (A5C) View - Regional Wall Anatomy on POCUS Echocardiogram

With either slight fanning or probe

rotation, the LVOT

Systolic Anterior Motion (SAM) of the Mitral Valve (MV)

Systolic anterior motion (SAM) describes the dynamic movement

outflow tract (LVOT

Syncope - Differential Diagnosis Algorithm
Neurocardiogenic:
• Vasovagal
• Orthostatic Hypotension
• Autonomic Neuropathy
• Situational (micturition,

Stenosis • HCM (LVOT

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