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Concurring hypertrophic cardiomyopathy and takotsubo cardiomyopathy: Assessment and management

Mohammed Abozenah1, Anis John Kadado1, Ahmad Aljamal2

  • 1Department of Internal Medicine, UMMS-Baystate Medical Center, Springfield, MA, USA.

Heart & Lung : the Journal of Critical Care
|November 4, 2020
PubMed

Insights

Takotsubo cardiomyopathy (TCM) co-occurring with hypertrophic cardiomyopathy (HOCM) is rare but manageable. This study suggests TCM may predispose HOCM patients to left ventricular outflow tract obstruction even after recovery.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Takotsubo cardiomyopathy (TCM) prevalence is increasing.
  • Co-occurrence of TCM with hypertrophic cardiomyopathy (HOCM) is uncommon.
  • HOCM significantly complicates TCM by increasing hemodynamic compromise risk.

Purpose of the Study:

  • To analyze the clinical characteristics, management, and outcomes of patients with co-occurring TCM and HOCM.
  • To investigate the potential for TCM to induce or exacerbate left ventricular outflow tract (LVOT) obstruction in HOCM.

Main Methods:

  • Retrospective analysis of patient cases with co-occurring TCM and HOCM.
  • Review of clinical data, including demographics, presentation, management strategies, and outcomes.
  • Assessment of LVOT gradient changes before, during, and after TCM resolution.

Main Results:

  • Patient demographics were similar to typical TCM cases.
  • Management mirrored standalone TCM, with increased use of inotropic agents and mechanical support.
  • Outcomes were generally favorable during hospitalization and at follow-up.
  • Approximately 50% of patients newly diagnosed with HOCM developed persistent LVOT obstruction post-TCM.

Conclusions:

  • TCM in the context of HOCM presents unique challenges but appears manageable with favorable outcomes.
  • A significant proportion of HOCM patients experienced persistent LVOT obstruction after TCM resolution.
  • Further research is needed to understand if TCM can predispose to LVOT obstruction in HOCM.

Keywords:
Hypertrophic cardiomyopathyLeft ventricular outflow tract obstructionLeft ventricular outflow tract peak gradientShockTakotsubo cardiomyopathy

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