Email this article Takotsubo syndrome with transient obstruction of the left ventricle outflow tract: A case report
- Authors: Maznev D.S.1, Evdokimov D.S.1, Evdokimova E.D.1
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol 15, No 3 (2024)
- Pages: 254-263
- Section: Case reports
- URL: https://ogarev-online.ru/2221-7185/article/view/281615
- DOI: https://doi.org/10.17816/CS631709
- ID: 281615
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Abstract
BACKGROUND: Modern data have expanded our understanding of the pathogenetic mechanisms and clinical and laboratory findings in a patient with Takotsubo syndrome (TS). Nonetheless, its timely diagnosis and treatment remain challenging. All patients are initially treated according to the acute coronary syndrome protocol, with a "working" diagnosis of myocardial infarction without an obstructive lesion in the coronary arteries. However, the treatment of in-hospital complications of TS has its limitations and specific features.
CLINICAL CASE DESCRIPTION: Herein, we have reported a case of TS that presented with the classic apical ballooning of the left ventricular apex, which had developed without an obvious stress factor, which is quite rare. The disease was complicated by the development of cardiogenic shock (CGS) and transient obstruction of the left ventricular outflow tract (LVOTO), which reportedly occurs in about 25% of the patients. CGS in patients with TS is a life-threatening complication and a challenging therapeutic problem, especially when it is also associated with a dynamic LVOTO. In such conditions, the only therapeutic option is mechanical circulatory support. However, in our patient, low doses of dobutamine were used to stabilize the patient’s hemodynamics. This treated produced a good therapeutic effect.
CONCLUSION: Our case report findings emphasize the need for further research into the mechanisms of LVOTO development in TS, as well as the development of standardized approaches for the treatment of such patients in the acute phase of the disease.
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##article.viewOnOriginalSite##About the authors
Dmitrii S. Maznev
North-Western State Medical University named after I.I. Mechnikov
Email: fonmaznev@gmail.com
ORCID iD: 0000-0001-5486-5251
SPIN-code: 7594-1896
MD, Cand. Sci. (Medicine)
Russian Federation, 41 Kirochnaya str., 191015 St. PetersburgDmitrii S. Evdokimov
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: kasabian244@gmail.com
ORCID iD: 0000-0002-3107-1691
SPIN-code: 5260-0063
Scopus Author ID: 57216438647
assistant
Russian Federation, 41 Kirochnaya str., 191015 St. PetersburgEkaterina D. Evdokimova
North-Western State Medical University named after I.I. Mechnikov
Email: katerina.resn_7@mail.ru
ORCID iD: 0000-0001-7889-3679
SPIN-code: 7271-3560
Scopus Author ID: 58915110600
student
Russian Federation, 41 Kirochnaya str., 191015 St. PetersburgReferences
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