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KMID : 1155520240190010062
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Anesthesia and Pain Medicine
2024 Volume.19 No. 1 p.62 ~ p.67
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Preoperative evaluation of systolic murmur with point-of-care echocardiography before an elective thoracic surgery - A case report -
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Lee Jae-Moon
Lee Min-Ki
Lee Soo-Kyung
Oh Chung-Sik
Kim Tae-Yop
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Abstract
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Background: Systolic murmur suggesting the association of aortic valve (AV) stenosis or obstructive pathology in the left ventricular outflow tract (LVOT) usually requires preoperative echocardiographic evaluation for elective surgery.
Case: In a 63-year-old female patient undergoing elective thoracic surgery, the systolic murmur was auscultated on the right sternal border of the second intercostal space in the preoperative patient holding area. Point-of-care (POC) transthoracic echocardiography (TTE) demonstrated a systolic jet flow in the LVOT area. The peak systolic velocity of the continuous wave Doppler tracing, aligned to the LVOT and the AV, was approximately 1.5 m/s. The peak/mean pressure gradient was 11/6 mmHg for the AV and 9/5 mmHg for the LVOT. Anesthesia was induced under continuous TTE imaging. Intraoperative transesophageal echocardiography also confirmed the absence of any cardiac pathology.
Conclusions: POC echocardiography offered a thorough preoperative evaluation of an unexpectedly identified systolic murmur, avoiding a potential delay in the operation schedule for conventional preoperative echocardiographic evaluation.
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KEYWORD
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Echocardiography, Point-of-care testing, Systolic murmurs, Ventricular outflow tract
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