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Takotsubo cardiomyopathy with LVOT obstruction in a case of STEMI: a rare cause of peri-PCI hypotension
  1. Shumail Fatima,
  2. Jared Romeo and
  3. John Pacella
  1. Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Shumail Fatima; fatimas{at}upmc.edu

Abstract

Takotsubo cardiomyopathy (TCM) associated with left ventricular outflow tract (LVOT) obstruction in the event of an ST-elevation myocardial infarction (STEMI) is a rare cause of hypotension during percutaneous coronary intervention (PCI). Herein, we describe a 57-year-old woman who presented with STEMI and underwent PCI. She developed hypotension which worsened during inotropic therapy. Echocardiography revealed evidence of LVOT obstruction in the setting of TCM. Therefore, inotropic support was promptly discontinued. Beta blockers and phenylephrine were rapidly administrated, resulting in improved blood pressure and stabilisation of the patient.

  • heart failure
  • interventional cardiology
  • clinical diagnostic tests

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Footnotes

  • Contributors SF contributed to writing the case report, formulating and editing the figures, tables and videos attached to the manuscript. JR contributed to editing and reviewing the manuscript. JP served as the faculty supervisor and reviewed the manuscript. He also contributed to the discussion part of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.