J Anesth Perioper Med. 2018;6(1):48-51. https://doi.org/10.24015/ebcmed.japm.2017.0059

Rocuronium-Induced Anaphylaxis Causing Systolic Anterior Motion of the Mitral Valve and Hemodynamic Collapse

Alexander D. Smith, Li H. Tan, and Con Giannellis

From the Department of Intensive Care, Epworth Hospital Richmond, Victoria, Australia.

Correspondence to Alexander D. Smith at alexander.smith@doctors.org.uk.

EBCMED ID: ebcmed.japm.2017.0059 DOI: 10.24015/ebcmed.japm.2017.0059


We present an unexpected case of systolic anterior motion of the mitral valve (SAM) caused by anaphylaxis to rocuronium, in a patient who presented for an elective total knee replacement. We present this case to increase clinical suspicion of both rocuronium anaphylaxis and SAM in the peri-operative patient who presents with shock, to highlight the importance of focussed echocardiography in the diagnosis of SAM, and to educate trainees on the acute management of the condition.

Article Type
Case Report

Declaration of Interests
The authors declare no conflicts of interest.

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