Transient left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve: A stunning cause
Christiaan Lucas Meuwese, Mohamed Boulaksil, Jeroen van Dijk, Jawed Polad, Huub W. Meijburg
Abstract
Christiaan Lucas Meuwese, Mohamed Boulaksil, Jeroen van Dijk, Jawed Polad, Huub 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.
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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.
Key concepts: Cardiology, Ventricular outflow tract obstruction, Medicine, Internal medicine, Stunning, Mitral valve, Rest (music), Myocardial stunning