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Published on: September 9, 2020
"Incompatible Housemates": Hypertrophic Obstructive Cardiomyopathy and Takotsubo Syndrome
Yasue Sato1, Kensuke Matsumoto1, Jun Sakai1
1Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Insights
This case report details a rare instance of takotsubo syndrome in an 81-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM). The combination led to severe left ventricular outflow tract obstruction (LVOTO) and cardiogenic shock, successfully managed with fluids, rhythm control, and beta-blockers.
Area of Science:
- Cardiology
- Internal Medicine
- Case Reports
Background:
- Hypertrophic obstructive cardiomyopathy (HOCM) is a condition characterized by thickening of the heart muscle.
- Takotsubo syndrome, also known as stress-induced cardiomyopathy, can mimic acute myocardial infarction.
- The co-occurrence of HOCM and takotsubo syndrome is rare and can lead to complex hemodynamic challenges.
Abstract:
This case report concerns an 81-year-old woman with previously well-controlled hypertrophic obstructive cardiomyopathy (HOCM). She was referred to our hospital because of the acute onset of takotsubo syndrome. Echocardiography revealed basal hyperkinesis due to takotsubo syndrome superimposed on septal hypertrophy, which resulted in the reappearance of prominent left ventricular outflow tract obstruction (LVOTO). Although she developed cardiogenic shock triggered by atrial fibrillation, LVOTO was successfully mitigated by aggressive fluid resuscitation, rhythm control, and the administration of β-blocker. We herein report a rare case with catastrophic hemodynamics due to the incidental combination of HOCM and takotsubo syndrome.
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