Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report

BACKGROUND: Modern data have expanded our understanding of the pathogenetic mechanisms and clinical and laboratory findings in a patient with Takotsubo syndrome (TS). Nonetheless, its timely diagnosis and treatment remain challenging. All patients are initially treated according to the acute coronar...

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Main Authors: Dmitrii S. Maznev, Dmitrii S. Evdokimov, Ekaterina D. Evdokimova
Format: Article
Language:English
Published: Concilium Medicum 2024-11-01
Series:КардиоСоматика
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Online Access:https://cardiosomatics.ru/2221-7185/article/viewFile/631709/pdf
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author Dmitrii S. Maznev
Dmitrii S. Evdokimov
Ekaterina D. Evdokimova
author_facet Dmitrii S. Maznev
Dmitrii S. Evdokimov
Ekaterina D. Evdokimova
author_sort Dmitrii S. Maznev
collection DOAJ
description BACKGROUND: Modern data have expanded our understanding of the pathogenetic mechanisms and clinical and laboratory findings in a patient with Takotsubo syndrome (TS). Nonetheless, its timely diagnosis and treatment remain challenging. All patients are initially treated according to the acute coronary syndrome protocol, with a "working" diagnosis of myocardial infarction without an obstructive lesion in the coronary arteries. However, the treatment of in-hospital complications of TS has its limitations and specific features. CLINICAL CASE DESCRIPTION: Herein, we have reported a case of TS that presented with the classic apical ballooning of the left ventricular apex, which had developed without an obvious stress factor, which is quite rare. The disease was complicated by the development of cardiogenic shock (CGS) and transient obstruction of the left ventricular outflow tract (LVOTO), which reportedly occurs in about 25% of the patients. CGS in patients with TS is a life-threatening complication and a challenging therapeutic problem, especially when it is also associated with a dynamic LVOTO. In such conditions, the only therapeutic option is mechanical circulatory support. However, in our patient, low doses of dobutamine were used to stabilize the patient’s hemodynamics. This treated produced a good therapeutic effect. CONCLUSION: Our case report findings emphasize the need for further research into the mechanisms of LVOTO development in TS, as well as the development of standardized approaches for the treatment of such patients in the acute phase of the disease.
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spelling doaj-art-b149990e95ed4dfaaed463ed9fb43b5f2025-08-20T03:13:10ZengConcilium MedicumКардиоСоматика2221-71852658-57072024-11-0115325426310.17816/CS63170976575Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case reportDmitrii S. Maznev0https://orcid.org/0000-0001-5486-5251Dmitrii S. Evdokimov1https://orcid.org/0000-0002-3107-1691Ekaterina D. Evdokimova2https://orcid.org/0000-0001-7889-3679North-Western State Medical University named after I.I. MechnikovNorth-Western State Medical University named after I.I. MechnikovNorth-Western State Medical University named after I.I. MechnikovBACKGROUND: Modern data have expanded our understanding of the pathogenetic mechanisms and clinical and laboratory findings in a patient with Takotsubo syndrome (TS). Nonetheless, its timely diagnosis and treatment remain challenging. All patients are initially treated according to the acute coronary syndrome protocol, with a "working" diagnosis of myocardial infarction without an obstructive lesion in the coronary arteries. However, the treatment of in-hospital complications of TS has its limitations and specific features. CLINICAL CASE DESCRIPTION: Herein, we have reported a case of TS that presented with the classic apical ballooning of the left ventricular apex, which had developed without an obvious stress factor, which is quite rare. The disease was complicated by the development of cardiogenic shock (CGS) and transient obstruction of the left ventricular outflow tract (LVOTO), which reportedly occurs in about 25% of the patients. CGS in patients with TS is a life-threatening complication and a challenging therapeutic problem, especially when it is also associated with a dynamic LVOTO. In such conditions, the only therapeutic option is mechanical circulatory support. However, in our patient, low doses of dobutamine were used to stabilize the patient’s hemodynamics. This treated produced a good therapeutic effect. CONCLUSION: Our case report findings emphasize the need for further research into the mechanisms of LVOTO development in TS, as well as the development of standardized approaches for the treatment of such patients in the acute phase of the disease.https://cardiosomatics.ru/2221-7185/article/viewFile/631709/pdftakotsubo syndromeleft ventricular outflow tract obstructioncardiomyopathy
spellingShingle Dmitrii S. Maznev
Dmitrii S. Evdokimov
Ekaterina D. Evdokimova
Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report
КардиоСоматика
takotsubo syndrome
left ventricular outflow tract obstruction
cardiomyopathy
title Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report
title_full Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report
title_fullStr Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report
title_full_unstemmed Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report
title_short Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report
title_sort takotsubo syndrome with transient obstruction of the left ventricle outflow tract a case report
topic takotsubo syndrome
left ventricular outflow tract obstruction
cardiomyopathy
url https://cardiosomatics.ru/2221-7185/article/viewFile/631709/pdf
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AT dmitriisevdokimov takotsubosyndromewithtransientobstructionoftheleftventricleoutflowtractacasereport
AT ekaterinadevdokimova takotsubosyndromewithtransientobstructionoftheleftventricleoutflowtractacasereport