Masked Hypotension due to Elevated Venous Pressure in a Patient with Complex Adult Congenital Heart Disease
Joint Authors
Rigger, Wytch
Javaheri, Sean P.
Sharma, Gyanendra K.
Nahman, Norris Stanley
Sheynshteyn, Mark
Weintraub, Neal L.
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-03-31
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
An adult with surgically corrected Tetralogy of Fallot presented with profoundly elevated central venous pressure (CVP) and acute renal dysfunction thought secondary to acute on chronic right heart failure.
Treatment with dopamine promoted diuresis and a stabilization of renal function.
Repeated attempts to wean the patient from dopamine were associated with hypotension and worsening renal failure.
Invasive hemodynamic assessment unexpectedly demonstrated high cardiac output with low systemic vascular resistance (SVR).
In retrospect, the markedly elevated CVP had concealed the impact of reduced SVR on blood pressure.
After reversible causes of low SVR state were excluded, the patient was successfully managed with oral alpha-adrenergic agents.
While typically negligible under physiologic conditions, elevated CVP can artificially increase mean arterial pressure.
We have coined the term “masked hypotension” to describe this unique pathophysiological phenomenon.
American Psychological Association (APA)
Rigger, Wytch& Javaheri, Sean P.& Sharma, Gyanendra K.& Nahman, Norris Stanley& Sheynshteyn, Mark& Weintraub, Neal L.. 2020. Masked Hypotension due to Elevated Venous Pressure in a Patient with Complex Adult Congenital Heart Disease. Case Reports in Cardiology،Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1146151
Modern Language Association (MLA)
Rigger, Wytch…[et al.]. Masked Hypotension due to Elevated Venous Pressure in a Patient with Complex Adult Congenital Heart Disease. Case Reports in Cardiology No. 2020 (2020), pp.1-4.
https://search.emarefa.net/detail/BIM-1146151
American Medical Association (AMA)
Rigger, Wytch& Javaheri, Sean P.& Sharma, Gyanendra K.& Nahman, Norris Stanley& Sheynshteyn, Mark& Weintraub, Neal L.. Masked Hypotension due to Elevated Venous Pressure in a Patient with Complex Adult Congenital Heart Disease. Case Reports in Cardiology. 2020. Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1146151
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1146151