Stress Cardiomyopathy in a Patient with Hypertrophic Cardiomyopathy: Case Presentation and Review of the Literature

Abstract

Stress cardiomyopathy and hypertrophic cardiomyopathy are two distinct entities with different pathophysiologic causes. In the recent medical literature their concurrency has been described. During the acute phase of a stress cardiomyopathy making the diagnosis of a concomitant hypertrophic cardiomyopathy may be challenging, and has important implications in both the acute and longterm clinical management. Herein, we present a case of a stress cardiomyopathy occurring in a patient with hypertrophic cardiomyopathy, along with a review of the literature.

Acute Left Ventricular Ballooning: Tools to Differentiate Hypertrophic Cardiomyopathy with Outflow Obstruction from Neurohumoral Takotsubo Syndrome

“…Our literature search yielded case series [ 7 , 8 , 9 , 12 , 13 , 14 ], case reports [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], one prospective cohort study [ 39 ], and one systematic review [ 40 ] that described cases of obstructive HCM with LV ballooning overlapping with neurohumoral Takotsubo syndrome (TTS). We propose key features to differentiate these diagnoses, as shown in Fig.…”

“…Although the above findings may be useful for differentiating TTS from HCM with latent obstruction and apical ballooning, the clinical evolution of the disease process over time is often the most useful for differentiating the two entities. Several case reports found that patients who presented acutely with LV apical ballooning and were diagnosed with TTS continued to show septal hypertrophy, LVOT obstruction, and mitral pathology for several weeks to months after initial presentation, and were ultimately diagnosed as HCM with obstruction [ 12 , 25 , 26 , 37 ]. Therefore, the continued evidence of such abnormalities on imaging after acute improvement of wall motion abnormalities would indicate the presence of underlying HCM.…”