Takotsubo cardiomyopathy and left ventricular outflow tract obstruction

Paul Fefer*, Anjala Chelvanathan, Alexander J. Dick, Earl J. Teitelbaum, Bradly H. Strauss, Eric A. Cohen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Takotsubo cardiomyopathy often presents to the cardiac catheterization laboratory masquerading as acute ST-elevation myocardial infarction (STEMI). Some of these patients present in shock secondary to dynamic left ventricular outflow tract (LVOT) obstruction. The typical patient is an elderly, hypertensive female with sigmoid deformity of the intraventricular septum. The management of hemodynamic instability in these patients is different from patients with STEMI. While hemodynamic instability in the setting of STEMI is usually treated with inotropic agents and intraaortic balloon counterpulsation, these therapies can increase LVOT pressure gradients in patients with takotsubo cardiomyopathy and lead to deepening of shock and worse outcomes. Thus accurate diagnosis and correct management are essential to prevent mortality in these patients, who will usually go on to have good long-term outcomes. This case report and literature review addresses the clinical characteristics, outcome, and management of these patients. (J Interven Cardiol 2009;22:444-452)

Original languageEnglish
Pages (from-to)444-452
Number of pages9
JournalJournal of Interventional Cardiology
Issue number5
StatePublished - Oct 2009
Externally publishedYes


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