Cardiogenic Shock in Obstructive Hypertrophic Cardiomyopathy Plus Apical Ballooning

Flavia Caniato, MD; Valentina Andrei, MD; Pasquale Bernardo, MD; Cecilia Agostini, MD; Francesco Cappelli, MD; Pier Luigi Stefano, MD; Iacopo Olivotto, MD; Maurizio Pieroni, MD; Leonardo Bolognese, MD; Carlo Di Mario, MD, PhD

JACC: Case Reports (Mar 2021)

Cardiogenic Shock in Obstructive Hypertrophic Cardiomyopathy Plus Apical Ballooning

Flavia Caniato, MD,
Valentina Andrei, MD,
Pasquale Bernardo, MD,
Cecilia Agostini, MD,
Francesco Cappelli, MD,
Pier Luigi Stefano, MD,
Iacopo Olivotto, MD,
Maurizio Pieroni, MD,
Leonardo Bolognese, MD,
Carlo Di Mario, MD, PhD

Affiliations

Flavia Caniato, MD: Cardiac Intensive Care Unit, Careggi University Hospital, Florence, Italy; Address for correspondence: Dr. Flavia Caniato, Cardiac Intensive Care Unit, Careggi University Hospital, Largo G. Alessandro Brambilla, 3, 50134 Florence, Italy.
Valentina Andrei, MD: Cardiac Intensive Care Unit, Careggi University Hospital, Florence, Italy
Pasquale Bernardo, MD: Cardiac Intensive Care Unit, Careggi University Hospital, Florence, Italy
Cecilia Agostini, MD: Cardiac Intensive Care Unit, Careggi University Hospital, Florence, Italy
Francesco Cappelli, MD: Cardiac Intensive Care Unit, Careggi University Hospital, Florence, Italy
Pier Luigi Stefano, MD: Cardiac Surgery Unit, Careggi University Hospital, Florence, Italy
Iacopo Olivotto, MD: Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
Maurizio Pieroni, MD: Cardiology Department, San Donato Hospital, Arezzo, Italy
Leonardo Bolognese, MD: Cardiology Department, San Donato Hospital, Arezzo, Italy
Carlo Di Mario, MD, PhD: Cardiac Intensive Care Unit, Careggi University Hospital, Florence, Italy

Journal volume & issue: Vol. 3, no. 3
pp. 433 – 437

Abstract

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A patient with known obstructive hypertrophic cardiomyopathy developed worsening left ventricular outflow tract obstruction, severe mitral regurgitation, and apical ballooning leading to cardiogenic shock, a combination in which treatment of each component could worsen the others. Emergency veno-arterial extracorporeal membrane oxygenation, levosimendan, and noradrenaline transiently restored adequate systemic perfusion and gas exchange. Surgical myectomy offered a more definitive solution. (Level of Difficulty: Intermediate.)

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

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Abstract

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