Takotsubo cardiomyopathy with transient left ventricular obstruction successfully treated with cibenzoline succinate:...

An 84-year-old woman was urgently referred to our hospital owing to persistent malaise and chest pain. Takotsubo cardiomyopathy was diagnosed following transthoracic echocardiography, emergency coronary angiography, and left ventriculography. A left ventricular pressure tracing during cardiac catheterization revealed a 72 mmHg-intraventricular pressure gradient (LVPG). Although β-blockers are effective at reducing LVPG in takotsubo cardiomyopathy, such treatment was contraindicated in our patient owing to her history of bronchial asthma. Therefore, we administered intravenous cibenzoline succinate to attenuate her LVPG. The LVPG decreased to 18 mmHg within 10 min after intravenous cibenzoline succinate administration. During her subsequent hospitalization, the patient showed excellent functional recovery, without any complications. Left ventriculography, performed 21 days after admission, showed normal wall motion and a left ventricular ejection fraction of 68%. <Learning objective: The prognosis of takotsubo cardiomyopathy is generally good, however, fatal complications have been reported. Our case demonstrated a LVPG of 72 mmHg, and β-blockers were contraindicated because of bronchial asthma. Intravenous cibenzoline administration resulted in successful attenuation of the patient's LVPG. The present case suggests that cibenzoline might be effective for the treatment of takotsubo cardiomyopathy, especially in those contraindicated for β-blocker therapy.>.