Actual incidence of global left ventricular hypokinesia
in adult septic shock.
In our case, severe global hypokinesia
was seen suggestive of myocarditis, and it improved with supportive treatment alone.
Repeated echocardiogram (ECG) revealed the same findings of his previous ECG (i.e., global hypokinesia
, EF of 15.0%, and severe MR).
Per the regions involved, the LV systolic dysfunction is divided into diffuse hypokinesia
and regional wall motion abnormality (RWMA).
An electrocardiogram (ECG) and echocardiogram were done.His ECG showed intra-ventricular conduction delay pattern and echocardiography showed grossly dilated and enlarged left ventricle with severely reduced left ventricular systolic function and global hypokinesia
. The left ventricular myocardium appeared to have a rugged appearance with prominent trabeculations seen projecting into the left ventricle cavity (Figure-1).
Direct catecholamine stress to the myocardium via bolus drug administration might have been the stimulus for TC in our patient in the presence of particularly elevated proBNP; however, the absence of hypokinesia
or motion wall abnormality on echocardiography and scintigraphy ruled out TC.
Echocardiography showed RHD, mild MS with severe MR, moderate tricuspid regurgitation (TR) and pulmonary hypertension (PHT), dilated left atrium (LA) and left ventricle (LV) with severe hypokinesia
, and LVEF of 20-25%.
Typical findings are disturbances of segmental contractility (apical hypokinesia
or akinesia), with normal epicardial coronary arteries.
Neurological abnormalities may include extrapyramidal dysfunction, such as hypomimia, muscle rigidity, bradykinesia and hypokinesia
. In patients with HE (pwHE), except for asterixis, which is actually negative myoclonus, parkinsonian-like tremor can also be seen (5,6).
The parasternal long axis view was remarkable for massive dilatation and hypokinesia
of the right ventricle (RV).
Common motor symptoms include reduced number and amplitude of movements (i.e., hypokinesia
), slowed movement (i.e., bradykinesia), rigidity, tremor, and instability, whereas cognitive symptoms include impaired working memory, attention, and cognitive flexibility [1-3].
Transthoracic echocardiogram (TTE) showed ejection fraction of 30% and global hypokinesia
(please see Supplementary Materials (available here)).