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Hypertrophic obstructive cardiomyopathy masked by tako-tsubo syndrome: a case report.

Daralammori Y, El Garhy M, Gayed MR, Farah A, Lauer B, Secknus MA - Case Rep Cardiol (2012)

Bottom Line: The prognosis under medical treatment of heart failure symptoms and watchful waiting is favourable.This paper supports this theory.However, TCM may also mask any preexisting LVOT obstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Heart Center, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437 Bad Berka, Germany.

ABSTRACT
Introduction. Left ventricular outflow obstruction might be part of the pathophysiological mechanism of Tako-tsubo cardiomyopathy. This obstruction can be masked by Tako-tsubo cardiomyopathy and diagnosed only by followup. Case Presentation. A 70-year-old female presented with Tako-tsubo cardiomyopathy and masked obstructive hypertrophic cardiomyopathy at presentation. Conclusion. Tako-tsubo cardiomyopathy typically presents like an acute MI and is characterized by severe, but transient, regional left ventricular systolic dysfunction. Prompt evaluation of the coronary status is, therefore, mandatory. The prognosis under medical treatment of heart failure symptoms and watchful waiting is favourable. Previous studies showed that LVOT obstruction might be part of the pathophysiological mechanism of TCM. This paper supports this theory. However, TCM may also mask any preexisting LVOT obstruction.

No MeSH data available.


Related in: MedlinePlus

Pressure tracings show a sharp rise in LV outflow gradient that follows the pause associated with PVC. A dynamic obstruction leads to a concomitant fall in aortic pressure and a disproportionate (46 to 130 mmHg) increase in gradient. This phenomenon, known as the Brockenbrough-Braunwald-Morrow sign, is part of the classical description of hypertrophic obstructive cardiomyopathy. Ao: aorta; ECG: electrocardiogram; LV: left ventricle; PVC: premature ventricular complex.
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fig5: Pressure tracings show a sharp rise in LV outflow gradient that follows the pause associated with PVC. A dynamic obstruction leads to a concomitant fall in aortic pressure and a disproportionate (46 to 130 mmHg) increase in gradient. This phenomenon, known as the Brockenbrough-Braunwald-Morrow sign, is part of the classical description of hypertrophic obstructive cardiomyopathy. Ao: aorta; ECG: electrocardiogram; LV: left ventricle; PVC: premature ventricular complex.

Mentions: On day four, a second invasive hemodynamic evaluation was performed, confirming a simultaneous pressure gradient between the LV and aorta of 45 mmHg at rest that increased to 70 mmHg after Valsalva maneuver (Figure 5). Pressure tracings of a postpremature ventricular contraction (PVC) beat showed a sharp rise of the LVOT gradient to 130 mmHg (Brockenbrough-Braunwald-Morrow sign), which is part of the classical description of hypertrophic obstructive cardiomyopathy [11].


Hypertrophic obstructive cardiomyopathy masked by tako-tsubo syndrome: a case report.

Daralammori Y, El Garhy M, Gayed MR, Farah A, Lauer B, Secknus MA - Case Rep Cardiol (2012)

Pressure tracings show a sharp rise in LV outflow gradient that follows the pause associated with PVC. A dynamic obstruction leads to a concomitant fall in aortic pressure and a disproportionate (46 to 130 mmHg) increase in gradient. This phenomenon, known as the Brockenbrough-Braunwald-Morrow sign, is part of the classical description of hypertrophic obstructive cardiomyopathy. Ao: aorta; ECG: electrocardiogram; LV: left ventricle; PVC: premature ventricular complex.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4008090&req=5

fig5: Pressure tracings show a sharp rise in LV outflow gradient that follows the pause associated with PVC. A dynamic obstruction leads to a concomitant fall in aortic pressure and a disproportionate (46 to 130 mmHg) increase in gradient. This phenomenon, known as the Brockenbrough-Braunwald-Morrow sign, is part of the classical description of hypertrophic obstructive cardiomyopathy. Ao: aorta; ECG: electrocardiogram; LV: left ventricle; PVC: premature ventricular complex.
Mentions: On day four, a second invasive hemodynamic evaluation was performed, confirming a simultaneous pressure gradient between the LV and aorta of 45 mmHg at rest that increased to 70 mmHg after Valsalva maneuver (Figure 5). Pressure tracings of a postpremature ventricular contraction (PVC) beat showed a sharp rise of the LVOT gradient to 130 mmHg (Brockenbrough-Braunwald-Morrow sign), which is part of the classical description of hypertrophic obstructive cardiomyopathy [11].

Bottom Line: The prognosis under medical treatment of heart failure symptoms and watchful waiting is favourable.This paper supports this theory.However, TCM may also mask any preexisting LVOT obstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Heart Center, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437 Bad Berka, Germany.

ABSTRACT
Introduction. Left ventricular outflow obstruction might be part of the pathophysiological mechanism of Tako-tsubo cardiomyopathy. This obstruction can be masked by Tako-tsubo cardiomyopathy and diagnosed only by followup. Case Presentation. A 70-year-old female presented with Tako-tsubo cardiomyopathy and masked obstructive hypertrophic cardiomyopathy at presentation. Conclusion. Tako-tsubo cardiomyopathy typically presents like an acute MI and is characterized by severe, but transient, regional left ventricular systolic dysfunction. Prompt evaluation of the coronary status is, therefore, mandatory. The prognosis under medical treatment of heart failure symptoms and watchful waiting is favourable. Previous studies showed that LVOT obstruction might be part of the pathophysiological mechanism of TCM. This paper supports this theory. However, TCM may also mask any preexisting LVOT obstruction.

No MeSH data available.


Related in: MedlinePlus