Tako-Tsubo Syndrome with Dynamic Left Ventricular Outflow Tract Obstruction and Mitral Regurgitation: A Case Report

Tako-tsubo syndrome is characterized by acute chest pain, dynamic ST-T change and elevated cardiac markers, mimicking acute coronary syndrome. Severe, but transient LV regional dysfunction, more commonly in apical area, and patent coronary arteries establish the clinical diagnosis. The underlying mechanism of this syndrome is not fully clarified. Coronary spasm, microcirculation dysfunction and catecholamine overload have been proposed as the possible causes of this syndrome. LV outflow tract obstruction has been reported as a possible contributor to this syndrome. We report a case of tako-tsubo syndrome with markedly increased LV outflow tract pressure gradient and dynamic mitral regurgitation. The possible role of LV outflow tract obstruction in the pathophysiologic process is discussed. Echocardiography is a useful tool to identify this abnormality and to guide the therapy.