Dynamic obstruction of the left ventricular outflow tract as a possible complication of takotsubo cardiomyopathy

Abstract

Takotsubo cardiomyopathy is a relatively benign condition characterized by stress-induced hypo- and akinesis of the apical segments of the myocardium against the background of intact function of the basal segments. With the addition of obstruction of the left ventricular outflow tract (LVOT) due to hyperkinesis of the basal segments, the patient’s condition and prognosis significantly worsens. In terms of hemodynamic parameters, this situation is similar to obstruction of LVOT in patients with hypertrophic cardiomyopathy, however, due to its rapid development, it can lead to the formation of acute heart failure against the background of low ejection syndrome and acute mitral insufficiency. This article presents a literature review, information on the epidemiology, pathophysiology and diagnosis of this disease, as well as a clinical case of the development of acute heart failure with obstruction of the left ventricular outflow tract and progression of takotsubo syndrome.