Meuwese Christiaan L, Boulaksil Mohamed, van Dijk Jeroen, Polad Jawed, Meijburg Huub W
Department of Cardiology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Echocardiography. 2017 Jul;34(7):1089-1091. doi: 10.1111/echo.13553. Epub 2017 May 12.
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.
左心室流出道梗阻（LVOTO）和二尖瓣收缩期前向运动（SAM）可能有多种病因，其中肥厚型心肌病最为常见。更罕见的是，急性冠状动脉综合征、心肌顿抑和应激性心肌病可能导致LVOTO和SAM。在此，我们报告一名70岁女性患者，因非ST段抬高型急性冠状动脉综合征接受经皮冠状动脉介入治疗。术后第二天，由于呼吸困难和低血压进行超声心动图检查，发现心尖运动减弱、LVOTO和SAM，在使用β受体阻滞剂治疗并经过2个月的随访期后，这些症状被证明完全可逆。结论是缺血后心尖顿抑导致了LVOTO和SAM。
