Abstract
Pulmonary oedema in a patient with hypertrophic subaortic stenosis undergoing extracorporeal shock wave lithotripsy is described. This event occurred upon emergence from the bath. It is suggested that pulmonary oedema followed emergence because of a reduction in central venous pressures and a decrease in preload which led to transient dynamic obstruction. Treatment with beta adrenergic blockade reduced outflow tract obstruction. Anaesthetists should be aware of the haemodynamic consequences of immersion and emersion with extracorporeal shock wave lithotripsy.
Résumé
Cette observation décrit un cas d’oedème pulmonaire chez une patiente porteuse d’un rétrécissement aortique sous-valvulaire qui subit une lithotripsie par ondes de choc. Cette complication est survenue à la sortie de la piscine. On suggère que l’étiologie de cet accident pourrait être la baisse de la tension veineuse centrale suivie d’un chute de la précharge qui a provoqué une obstruction dynamique du retour veineux. Le traitement inhibiteur β-adrénergique a réduit l’obstruction à l’écoulement veineux sanguin. Les anesthésistes doivent être alertés sur les conséquences de l’immersion et de l’émersion de la lithotripsie par ondes de choc.
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Wulfson, H.D., LaPorta, R.F. Pulmonary oedema after lithotripsy in a patient with hypertrophic subaortic stenosis. Can J Anaesth 40, 465–467 (1993). https://doi.org/10.1007/BF03009519
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DOI: https://doi.org/10.1007/BF03009519