"Systolic anterior motion"(SAM): una causa infrecuente de hipotensión severa en el perioperatorio de cirugía no cardiaca
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Mario Concha [1] ; Verónica Mertz K [1]
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[1] Pontificia Universidad Católica de Chile
Pontificia Universidad Católica de Chile
Santiago, Chile
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- Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 140, Nº. 8, 2012, págs. 1046-1049
- Idioma: español
- Títulos paralelos:
- Systolic anterior motion: A report of two cases
- Enlaces
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Resumen
Background: Systolic anterior motion describes the anterior displacement of one or both mitral valve leaflets, obstructing the outflow tract of the left ventricle. It can be a cause of severe hypotension during the intraoperative and postoperative period of non-cardiac surgery. The diagnosis is made with echocardiography. We report two patients with this problem. The first was a 74-year-old male subjected to an incisional hernia repair who presented severe hypotension in the intraoperative period. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Epinephrine was discontinued and Norepinephrine and a volume expander were administered, with good response. The second patient was a 64-year-old male undergoing a right liver lobectomy. In the postoperative period, he suffered severe hypotension. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Dobutamine was discontinued, volume was administered, and a Norepinephrine infusion was started with good response.
