scholarly journals Dynamic obstruction of the left ventricular outflow tract as a possible complication of takotsubo cardiomyopathy

2021 ◽  
Vol 2 (3) ◽  
pp. 94-105
Author(s):  
E. K. Donets ◽  
A. M. Namitokov ◽  
S. V. Kruchinova ◽  
H. D. Kosmacheva

Takotsubo cardiomyopathy is a relatively benign condition characterized by stress-induced hypo- and akinesis of the apical segments of the myocardium against the background of intact function of the basal segments. With the addition of obstruction of the left ventricular outflow tract (LVOT) due to hyperkinesis of the basal segments, the patient’s condition and prognosis significantly worsens. In terms of hemodynamic parameters, this situation is similar to obstruction of LVOT in patients with hypertrophic cardiomyopathy, however, due to its rapid development, it can lead to the formation of acute heart failure against the background of low ejection syndrome and acute mitral insufficiency. This article presents a literature review, information on the epidemiology, pathophysiology and diagnosis of this disease, as well as a clinical case of the development of acute heart failure with obstruction of the left ventricular outflow tract and progression of takotsubo syndrome.

2012 ◽  
Vol 50 (No. 7) ◽  
pp. 321-326
Author(s):  
J. Pikula ◽  
J. Pikulova ◽  
H. Bandouchova ◽  
P. Kohout ◽  
K. Najman ◽  
...  

A combined congenital heart defect of aortic stenosis and mitral dysplasia was diagnosed in three Black Russian Terrier puppies two months old. The aortic stenosis component included both fixed and dynamic obstructions. The fixed obstruction was subvalvularly located at the entrance to the left ventricular outflow tract. The dynamic obstruction was caused by the septal leaflet of the mitral valve protruding into the left ventricular outflow tract. Mitral dysplasia resulted in mitral insufficiency leading to regurgitation through the mitral valve closer to the septal side. The maximum pressure gradient across the aortic valve amounting to 103 mmHg measured in one puppy was consistent with the most severe grade of stenosis. The diagnosis was confirmed by autopsy in all three puppies that were males and originated in one litter, so genetic influences are supposed.


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