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Severe hypertrophic cardiomyopathy with left ventricular outflow tract obstruction identified with preprocedural point-of-care ultrasound before emergent tracheal repair
  1. Sara Biladeau and
  2. Ryan Grell
  1. Anesthesiology, University of Louisville School of Medicine, Louisville, Kentucky, USA
  1. Correspondence to Dr Ryan Grell; ryangrell{at}


A woman in her 60s was brought to the operating room directly from the trauma bay for emergent intervention to repair a tracheal rupture sustained during a reported fall from standing height. She was intubated and sedated prior to arrival by paramedics for respiratory distress. Her family reported that the patient had dizziness after standing followed by the patient fainting and striking her neck. During a preprocedural point-of-care cardiac ultrasound examination, we discovered severe left ventricular hypertrophy with a significantly increased ejection fraction and decreased left ventricular cavity size. This prompted emergent cardiology consultation, which confirmed the presence of severe hypertrophic cardiomyopathy with left ventricular outflow tract obstruction. After a brief delay to optimise her heart rate and volume status, the patient successfully underwent an open reduction and internal fixation of the laryngeal cartilage and was discharged in stable condition with plans to undergo a septal myotomy.

  • Anaesthesia
  • Cardiovascular medicine
  • Medical education
  • Otolaryngology / ENT
  • Ultrasonography

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  • Contributors SB and RG provided clinical care for this patient and jointly created this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.