Despite considerable interest in the syndrome of acute left ventricular (LV) ballooning, its pathophysiology has remained ill-defined. In this review, we explore observational data describing two etiologies of acute LV ballooning: neurohumoral classic Takotsubo Syndrome (TTS), and acute severe unrelenting left ventricular outflow tract (LVOT) obstruction in patients with obstructive hypertrophic cardiomyopathy (HCM). We describe the clinical presentation and varying pathophysiology of these presentations, explore how echocardiography and cardiac catheterization may help differentiate between the two etiologies, and detail differences in management. We highlight the significant overlap as well as key differentiating features of these conditions, with the aim to improve diagnostic awareness and accuracy and appropriately tailor therapy.
Cite this article
Volume | Year
Open Access Review
Acute Left Ventricular Ballooning: Tools to Differentiate Hypertrophic Cardiomyopathy with Outflow Obstruction from Neurohumoral Takotsubo Syndrome
1 Hypertrophic Cardiomyopathy Program, Leon H. Charney Division of Cardiology, Department of Medicine, New York University Langone Health, New York, NY 10016, USA
2 Interventional Cardiology, Leon H. Charney Division of Cardiology, Department of Medicine, New York University Langone Health, New York, NY 10016, USA
*Correspondence: Arushi.firstname.lastname@example.org (Arushi Singh)
Rev. Cardiovasc. Med. 2023, 24(5), 154; https://doi.org/10.31083/j.rcm2405154
Submitted: 26 September 2022 | Revised: 13 February 2023 | Accepted: 27 March 2023 | Published: 19 May 2023
(This article belongs to the Special Issue Pathophysiology, Diagnosis, Treatment, and Prognosis of TakoTsubo Syndrome (TTS) What is Known and What is to be Known – Volume 2)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
obstructive hypertrophic cardiomyopathy
left ventricular outflow tract obstruction
left heart catheterization