Saturday, March 17, 2018


Q: All of the following are parts of management for hemodynamically significant Left Ventricular Outflow Tract (LVOT) obstruction except?

A) Intravenous volume (IVF)
B) Vasoconstrictors without chronotropic properties to increase Systemic Vascular Resistence (SVR)
C) Use of Inotrope 
D) Decrease Heart Rate (HR)
E) All of the above

Answer: C

Hypertrophied Left Ventricle by default has reduced compliance, and very much dependent on preload. 
Hypovolemia will worsen the hemodynamics and vice versa. Similarly, vasodilatation  is detrimental.

Tachycardyia and strong inotropy will leave no time and space for left ventricular cavity to fill up and will ensue cardiogenic collapse. Bradycardia is preferred.

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