A clinical case of apical ballooning of the left ventricle as a manifestation of takotsubo syndrome in combination with obstructive hypertrophic cardiomyopathy

The article presents a clinical case of a 49-year-old man with a long history of alcohol abuse, type 2 diabetes mellitus and hypertension, who was hospitalized with symptoms of acute heart failure. Coronary angioventriculography excluded significant atherosclerotic lesions of the coronary arteries, revealed apical ballooning of the left ventricle (LV), and suspected takotsubo syndrome (TS). Subsequent examination revealed hyperglycemia, increased troponin I levels, decreased global contractility of the LV myocardium, and signs of obstructive hypertrophic cardiomyopathy (HCM). During inpatient treatment, including infusion therapy, beta-blockers and glucose monitoring, the patient's condition improved. Subsequent studies conducted at the outpatient stage confirmed the presence of HCM with a dynamic decrease in the degree of LV outflow tract obstruction, indicating a complex interaction between ST, HCM and withdrawal syndrome against the background of alcohol dependence. This case emphasizes the importance of differential diagnosis and an integrated approach to the treatment of patients with multiple comorbidities.