Key result
Beta-blocker treatment completely reverses transient LVOTO and SAM caused by postischemic apical stunning.
Case Report (n=1)
Highlights postischemic apical stunning as a rare, reversible cause of transient LVOTO and SAM following acute coronary syndrome.
Post-PCI LVOTO/SAM detection in NSTE-ACS warrants vigilance; Level 3 cohort data leave incidence and management implications open.
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.
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Meuwese et al. (2017) conducted a case report in Non-ST-elevation acute coronary syndrome with transient LVOTO and SAM (n=1). Beta-blocker was evaluated on Reversibility of LVOTO and SAM. Treatment with a beta-blocker completely reversed transient left ventricular outflow tract obstruction and systolic anterior motion of the mitral valve caused by postischemic apical stunning.
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