Transient left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve: A stunning cause

Echocardiography
Christiaan L MeuweseHuub W Meijburg

Abstract

Left ventricular outflow tract obstruction (LVOTO) and systolic anterior motion (SAM) of the mitral valve may have various etiologies, of which hypertrophic cardiomyopathy is the most common. More rarely, an acute coronary syndrome, myocardial stunning, and takotsubo cardiomyopathy may give rise to LVOTO and SAM. Here, we present a 70-year-old female patient with a non-ST-elevation acute coronary syndrome treated with percutaneous coronary intervention. Echocardiography the day after, because of dyspnea and hypotension, revealed apical akinesia, LVOTO, and SAM, which proved completely reversible after treatment with a β-blocker and a 2-month follow-up period. It was concluded that postischemic apical stunning had caused LVOTO and SAM.

References

Jan 13, 2001·Mayo Clinic Proceedings·R P VillarealJ M Wilson
Jun 22, 2012·European Heart Journal·Roberto SpoladoreIacopo Olivotto
Aug 10, 2012·Lancet·Barry J Maron, Martin S Maron
Jul 19, 2013·Coronary Artery Disease·Guido ParodiUNKNOWN Tako-tsubo Italian Network (TIN)
Sep 4, 2015·The New England Journal of Medicine·Christian TemplinThomas F Lüscher

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