PMC9231567_01
Presenting electrocardiogram showed T-wave inversions in the inferior leads.
mdcvj-18-1-1100-g1.jpg
PMC9231567_01_mdcvj-18-1-1100-g1.jpg
F1
Electrocardiogram showed T-wave inversions in the inferior leads (Figure 1).
Coronary artery catheterization revealed a (A) dominant right coronary artery, (B) left anterior descending artery with no flow-limiting lesions, and (C) left circumflex artery and obtuse marginal branch with no flow-limiting disease.
mdcvj-18-1-1100-g2.jpg
PMC9231567_01_mdcvj-18-1-1100-g2.jpg
F2
Catheterization demonstrated no significant coronary artery disease (Figure 2) but did show significant left ventricular to aortic pullback gradient, suggesting Takotsubo cardiomyopathy-related left ventricular outflow tract obstruction (LVOT).
Echocardiogram demonstrated left ventricular outflow tract dynamic obstruction of 85 mm Hg.
mdcvj-18-1-1100-g3.jpg
PMC9231567_01_mdcvj-18-1-1100-g3.jpg
F3
EF of 30%, and hypotension, we elected to manage her with cautious diuresis and intra-aortic balloon pump (IABP) placement, with planned IABP removal the next morning. Echocardiogram confirmed the diagnosis of Takotsubo cardiomyopathy with an LVOT dynamic obstruction of 85 mm Hg and systolic anterior motion of the mitral valve (Figure 3; Video 1).