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Severe hypertrophic cardiomyopathy with left ventricular outflow tract obstruction identified with preprocedural point-of-care ultrasound before emergent tracheal repair


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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