Journal de médecine vasculaire et de chirurgie

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Transient Left Ventricular Outflow Obstruction in Tako Tsubo- Syndrome: A Case Report

Nilda Espinola-Zavaleta, Moisés Levinstein-Jacinto, Jose Alfredo Carballo Quiñones and Manuel de la Llata-Romero

This is a clinical case of an 83-years-old woman referred to our hospital for the occurrence of chest pain and syncope, related to an intense emotional stress in the previous three months. At admission, the electrocardiogram showed S-T segment elevation from V1-V3 and deep inversion of the T-wave in V4-V6, and an increase in troponin I level (6.4 ng/mL). Echocardiogram demonstrated midapical segment akinesia with left ventricular dysfunction. Basal segments were hypercontractile and there was evidence of left ventricular outflow tract (LVOT) obstruction with an end-systolic peak gradient of 99 mmHg. Regression of the LVOT obstruction was detected at third day. Three weeks after admission a serial two-dimensional echocardiography and nuclear medicine studies showed a complete regression of the left ventricular wall motion abnormalities with an improvement of systolic function.