Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 131

This complication occurs in 1–2% of MIs and up to 12% of anterior MIs in women. It is due to anteroapical akinesis associated with a compensatory hyperkinesis of the LV base. This narrows the LVOT and leads to drawing of the mitral valve to the septum and systolic ante- rior motion (SAM) of the mitral valve, similar to HOCM (Figure 2.6).¹³¹

Hypotension and pulmonary edema may subsequently occur. Clinically, a new, dynamic systolic murmur, similar to HOCM murmur, is heard. MR murmur (SAM) may also be heard.

As opposed to the treatment of cardiogenic shock, inotropes, diuretics, and IABP should be avoided, as they worsen the basal hyper- kinesis and LVOT narrowing. β-Blockers are used to reduce the LVOT hyperkinesis. α-Agonists may be used in case of hypotension.