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Takotsubo Cardiomyopathy in a Patient with Preexisting Hypertrophic Cardiomyopathy

Sherif Elhosseiny1, Jonathon Spagnola2, Roman Royzman2

  • 1Internal Medicine, Staten Island University Hospital, Staten Island, USA.

Cureus
|January 19, 2019
PubMed

Insights

Takotsubo cardiomyopathy (TCM) in a patient with hypertrophic cardiomyopathy (HCM) presented a unique challenge with an increased left ventricular outflow tract gradient. Continuous monitoring and supportive care are crucial for managing this rare presentation.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine

Background:

  • Takotsubo cardiomyopathy (TCM) involves transient left ventricular dysfunction, mimicking myocardial infarction without coronary artery disease.
  • Hypertrophic cardiomyopathy (HCM) is a genetic condition causing left ventricular hypertrophy.

Observation:

  • A male patient with a history of HCM developed TCM.
  • This rare co-occurrence led to a previously undocumented increased left ventricular outflow tract (LVOT) gradient.

Findings:

  • The TCM presented with an elevated LVOT gradient, a novel finding in this patient's cardiac history.
  • Hemodynamic assessment was complicated by the dynamic LVOT obstruction.

Implications:

  • This case highlights the importance of recognizing and monitoring for dynamic LVOT obstruction in patients with coexisting TCM and HCM.
  • Management requires careful assessment, continuous monitoring, and supportive care, including beta-blockers and echocardiographic surveillance.

Keywords:
acute coronary syndromehypertrophic obstructive cardiomyopathytakotsubo cardiomyopathy

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