Hyperdynamic LV

History

An elderly gentleman presented with fevers, cough and hypotension. Peripheries were warm.

Ultrasound Findings

The LV is hyperdynamic with the walls “kissing”. There is a small pericardial effusion (which is of no haemodynamic significance)

Conclusion

Hyperdynamic left ventricle

Learning point

A small, hyperdynamic LV can be seen in sepsis, anaphylaxis and also massive PE. The lack of RV enlargement and septal flattening exclude PE from the diagnosis. In the setting of hypotension or shock, the patient should be given IV fluid.

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