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Transient left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve: A stunning cause
Authors:Christiaan L. Meuwese MD  PhD  Mohamed Boulaksil MD  PhD  Jeroen van Dijk MD  PhD  Jawed Polad MBChB  MRCP  Huub W. Meijburg MD  PhD
Affiliation:1. Department of Cardiology, Jeroen Bosch Hospital, ‘s‐Hertogenbosch, The Netherlands;2. Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands;3. Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
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.
Keywords:left ventricular outflow tract obstruction  systolic anterior motion of the mitral valve  myocardial stunning  percutaneous intervention
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