Intra-Aortic Balloon Pump Exacerbates Left Ventricular Outflow Tract Obstruction in a Patient With Takotsubo and Hypertrophic Cardiomyopathy

Griffin, Matthew; Odanovic, Natalija; McNamara, Robert; Altin, S. Elissa; Balan, Samantha; Thompson, Jazmyn; Young, Lawrence H.

doi:10.1016/j.case.2023.07.003

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…Therefore, it is contraindicated in the presence of LVOTO. 52 , 55 In cases of refractory cardiogenic shock with organ hypoperfusion, use of venoarterial extracorporeal membrane oxygenation may be preferred, depending on center expertise and availability. 8 , 18 It is important to emphasize that due to the lack of a randomized controlled trial, current recommendations are based only on case reports, retrospective studies, and expert opinions.…”

Section: Decision Hubs and Therapymentioning

confidence: 99%

Obstructive Hypertrophic Cardiomyopathy and Takotsubo Syndrome: How to Deal With Left Ventricular Ballooning?

Citro,

Bellino,

Merli

et al. 2023

JAHA

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Currently, there are 2 proposed causes of acute left ventricular ballooning. The first is the most cited hypothesis that ballooning is caused by direct catecholamine toxicity on cardiomyocytes or by microvascular ischemia. We refer to this pathogenesis as Takotsubo syndrome. More recently, a second cause has emerged: that in some patients with underlying hypertrophic cardiomyopathy, left ventricular ballooning is caused by the sudden onset of latent left ventricular outflow tract obstruction. When it becomes severe and unrelenting, severe afterload mismatch and acute supply–demand ischemia appear and result in ballooning. In the context of 2 causes, presentations might overlap and cause confusion. Knowing the pathophysiology of each mechanism and how to determine a correct diagnosis might guide treatment.

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Section: Decision Hubs and Therapymentioning

confidence: 99%

Obstructive Hypertrophic Cardiomyopathy and Takotsubo Syndrome: How to Deal With Left Ventricular Ballooning?

Citro,

Bellino,

Merli

et al. 2023

JAHA

View full text Add to dashboard Cite

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Inpatient outcomes of mechanical circulatory support devices and heart transplantation in hypertrophic cardiomyopathy

Hussain,

Tarabanis,

Aslam

et al. 2024

International Journal of Cardiology

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Tailored Therapies for Cardiogenic Shock in Hypertrophic Cardiomyopathy: Navigating Emerging Strategies

Zakynthinos,

Gialamas,

Tsolaki

et al. 2024

JCDD

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Hypertrophic cardiomyopathy (HCM) is a complex and heterogeneous cardiac disorder, often complicated by cardiogenic shock, a life-threatening condition marked by severe cardiac output failure. Managing cardiogenic shock in HCM patients presents unique challenges due to the distinct pathophysiology of the disease, which includes dynamic left ventricular outflow tract obstruction, diastolic dysfunction, and myocardial ischemia. This review discusses current and emerging therapeutic strategies tailored to address the complexities of HCM-associated cardiogenic shock and other diseases with similar pathophysiology that provoke left ventricular outflow tract obstruction. We explore the role of pharmacological interventions, including the use of vasopressors and inotropes, which are crucial in stabilizing hemodynamics but require careful selection to avoid exacerbating the outflow obstruction. Additionally, the review highlights advancements in mechanical circulatory support devices such as extracorporeal membrane oxygenation (ECMO) and left ventricular assist devices (LVADs), which have become vital in the acute management of cardiogenic shock. These devices provide temporary support and bridge patients to recovery, definitive therapy, or heart transplantation, which remains a critical option for those with end-stage disease. Furthermore, the review delves into the latest research and clinical trials that are refining these therapeutic approaches, ensuring they are optimized for HCM patients. The impact of these treatments on patient outcomes, including survival rates and quality of life, is also critically assessed. In conclusion, this review underscores the importance of a tailored therapeutic approach in managing cardiogenic shock in HCM patients, integrating pharmacological and mechanical support strategies to improve outcomes in this high-risk population.

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Intra-Aortic Balloon Pump Exacerbates Left Ventricular Outflow Tract Obstruction in a Patient With Takotsubo and Hypertrophic Cardiomyopathy

Cited by 3 publications

References 12 publications

Obstructive Hypertrophic Cardiomyopathy and Takotsubo Syndrome: How to Deal With Left Ventricular Ballooning?

Obstructive Hypertrophic Cardiomyopathy and Takotsubo Syndrome: How to Deal With Left Ventricular Ballooning?

Inpatient outcomes of mechanical circulatory support devices and heart transplantation in hypertrophic cardiomyopathy

Tailored Therapies for Cardiogenic Shock in Hypertrophic Cardiomyopathy: Navigating Emerging Strategies

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