Takotsubo Cardiomyopathy in a Patient with Preexisting Hypertrophic Cardiomyopathy

Abstract

Takotsubo cardiomyopathy (TCM) is a condition characterized by transient left ventricular dysfunction and apical ballooning, best seen on an echocardiogram or left ventriculogram. It mimics acute myocardial infarction but without evidence of coronary artery disease on an angiogram. Hypertrophic cardiomyopathy (HCM) is an autosomal dominant heart muscle disease that is significant with hypertrophy of the left ventricle with various morphologies. We hereby report a case of TCM in a male patient with a known history of HCM. The patient’s hemodynamic findings were challenging because the TCM produced an increased left ventricular outflow tract (LVOT) gradient that was previously not seen on his prior echocardiogram or cardiac catheterizations. Assessment and continuous monitoring are warranted in such a rare case. Supportive care afterward with beta blockers, along with echocardiogram surveillance, are the mainstay of management of such a patient.

Syncope in a hypertrophic heart at a wedding party: can happiness break a thick heart? Takotsubo cardiomyopathy complicated with left ventricular outflow tract obstruction in a hypertrophic heart

“…It is interesting that the syncopal episode occurred during dinner at a wedding party, where most likely the increased vagal tone augmented the degree of LVOT obstruction because of decreased blood pressure, eventually leading to the syncopal episode. Thus, the combination of septal hypertrophy along with TCM can lead to a more severe clinical presentation [7][8][9][10].…”