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Case Reports
. 2022 Mar 15;14(3):e23168.
doi: 10.7759/cureus.23168. eCollection 2022 Mar.

Successful Treatment of Cardiogenic Shock Due to Takotsubo Cardiomyopathy With Left Ventricular Outflow Tract Obstruction and Acute Mitral Regurgitation by Impella CP

Ales Benak  1 , Marek Sramko  1 , Bronislav Janek  1 , Michael Zelizko  1 , Josef Kautzner  1
Affiliations
Case Reports

Successful Treatment of Cardiogenic Shock Due to Takotsubo Cardiomyopathy With Left Ventricular Outflow Tract Obstruction and Acute Mitral Regurgitation by Impella CP

Ales Benak et al. Cureus. .

Abstract

Treatment of Takotsubo cardiomyopathy (TC) with left ventricular outflow obstruction (LVOTO) remains challenging. Mechanical circulatory support (MCS) as a bridge to myocardial recovery is sometimes the only therapeutic option, even though the optimal type of MCS is still under debate. This report describes a case of TC complicated by cardiogenic shock due to LVOTO and severe mitral regurgitation that was successfully treated with the latest generation percutaneous pump Impella CP®.

Keywords: apical ballooning syndrome; cardiogenic shock; impella; left ventricular outflow tract obstruction; mechanical circulatory support; takotsubo.

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Conflict of interest statement

The authors have declared financial relationships, which are detailed in the next section.

Figures

Figure 1
Figure 1. (a) Severe mitral valve regurgitation caused by the systolic anterior motion of the anterior leaflet of the mitral valve. (b) Severe left ventricular outflow tract obstruction (peak pressure gradient of 144 mmHg).
Figure 2
Figure 2. LV angiogram illustrating the typical finding of Takotsubo cardiomyopathy with severe mitral valve regurgitation.
Figure 3
Figure 3. Cardiac magnetic resonance imaging proved normal function LV with no abnormalities in the LV kinetics (a, b) and no LGE (c, d).
(a) Cine diastole, (b) cine systole, (c) LGE short axis, (d) LGE four chambers LGE - late gadolinium enhancement
See this image and copyright information in PMC

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