title: Reappearance of the left ventricular pressure gradient in a patient with hypertrophic obstructive cardiomyopathy.
abstract: An 84-year-old woman diagnosed with hypertrophic obstructive cardiomyopathy (HOCM) was referred to our hospital due to chest pain associated with an increased level of troponin T. Following the administration of cibenzoline, the left ventricular outflow pressure gradient (LVPG) completely disappeared. Left ventricular pressure pullback tracing subsequently demonstrated the "reappearance" of the LVPG. Left ventriculography showed apical ballooning with excessive contractions at the base of heart, and we therefore made a diagnosis of Takotsubo cardiomyopathy in a patient with HOCM. Hypercontractions of the base of the heart associated with Takotsubo cardiomyopathy may be responsible for the "reappearance" of LVPG in this case.
authors.affiliation: Department of Cardiology, Uwajima City Hospital, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ochiumi
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Ikeda
authors.forename: Mareomi
authors.initials: M
authors.lastname: Hamada
mesh_terms: D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D002637:Chest Pain / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D007093:Imidazoles / Q000627:therapeutic use*; D012720:Severity of Illness Index; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood; D017725:Ventricular Pressure / Q000187:drug effects*
chemical_list: D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; D020107:Troponin T; C032151:cifenline