Dynamic left ventricular outflow tract obstruction in apical ballooning syndrome (Takotsubo cardiomyopathy).
Patients with apical ballooning syndrome may develop dynamic left ventricular outflow obstruction due to systolic anterior motion of the mitral valve leaflet and secondary functional mitral regurgitation, causing decreased cardiac output and hypotension. If suspected, bedside echocardiography will quickly confirm this complication. Positive inotropic/chronotropic agents should be avoided as they may exacerbate outflow tract obstruction, resulting in further hemodynamic compromise.
Department of Medicine, Mayo Clinic, Rochester, MN, USA liangjac@msu.edu.
J J
JJ
Liang
Department of Medicine, Mayo Clinic, Rochester, MN, USA.
C D
CD
Janish
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
K G
KG
Bishu
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
G S
GS
Reeder
D000368:Aged; D004452:Echocardiography; D005260:Female; D006801:Humans; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000503:physiopathology; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000209:etiology*
Takotsubo; apical ballooning syndrome; dynamic outflow tract obstruction; hypotension; mitral regurgitation; systolic anterior motion