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Case Reports

Open Access Special Issue

Cardiac Arrest Due to Severe Dynamic Left Ventricular Outflow Obstruction and Hypertrophy Following Anesthesia Induction

  • Michael F Harrison1,2
  • Neil G Feinglass3
  • Emir Festic1

1Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA

2Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA

3Department of Anesthesiology and Perioperative Medicine, Jacksonville, FL, USA

DOI: 10.22514/sv.2020.16.0071 Vol.16,Issue 2,October 2020 pp.207-209

Published: 28 October 2020

(This article belongs to the Special Issue Emergency Department Cardiac Arrest (EDCA))

*Corresponding Author(s): Emir Festic E-mail:


Cardiac arrest following induction of general anesthesia is a rare event. A 47-year-old woman with a history of chronic neck pain secondary to spinal stenosis presented for elective cervical laminectomy. Induction of general anesthesia induced cardiac arrest and emergency insertion of the transesophageal echocardiogram probe identified severe, undiagnosed left ventricular hypertrophy with dynamic outflow obstruction. Resuscitative treatment was immediately implemented to include aggressive intravenous fluid resuscitation, intravenous esmolol and phenylephrine to augment preload, afterload, and reflex bradycardia effect. Return of spontaneous circulation was achieved and the patient was admitted to the ICU, where she was extubated with preserved neurocognitive function on the same day. Our case describes the risk presented by undiagnosed cardiac abnormalities in what was accepted as a low-to-intermediate risk patient undergoing an elective procedure. The increasing popularity and use of pocket-sized handheld ultrasound devices may help reduce the risk of occurrences such as this in the future.


Cardiac arrest, Cardiomyopathy, Hypertrophic, Echocardiogram, Transesophageal

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Michael F Harrison,Neil G Feinglass,Emir Festic. Cardiac Arrest Due to Severe Dynamic Left Ventricular Outflow Obstruction and Hypertrophy Following Anesthesia Induction. Signa Vitae. 2020. 16(2);207-209.


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