{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:40:22Z","timestamp":1762508422992,"version":"3.41.2"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Takotsubo cardiomyopathy is a variant of acute coronary syndrome with characteristic acute left ventricular apical ballooning. Uncommonly, there can be associated left ventricular outflow tract (LVOT) obstruction causing cardiogenic shock refractory to inotropic support. The use of afterload-reducing mechanical support such as intra-aortic balloon pump (IABP) counterpulsation is not routinely employed in instances of this kind.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>In our case report, we describe a 66-year-old female with acute Takotsubo cardiomyopathy and associated LVOT obstruction which failed to respond to high-dose dobutamine and whose clinical trajectory was worsened by fast atrial fibrillation with rapid ventricular response. Within 24\u2009h of admission, the patient had an IABP placed which rapidly improved her haemodynamics. Two days later, IABP was removed and within 6\u2009days of admission, apical ballooning and LVOT obstruction had fully recovered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We recommend early use of mechanical support with IABP counterpulsation to expedite recovery in patients with acute Takotsubo cardiomyopathy with associated LVOT obstruction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab082","type":"journal-article","created":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T18:55:58Z","timestamp":1615143358000},"source":"Crossref","is-referenced-by-count":5,"title":["Dynamic left ventricular outflow tract gradient resulting from Takotsubo cardiomyopathy ameliorated by intra-aortic balloon pump counterpulsation: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8190-5714","authenticated-orcid":false,"given":"Jim","family":"O\u2019Brien","sequence":"first","affiliation":[{"name":"Department of Cardiology, Mater Private Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1300-1235","authenticated-orcid":false,"given":"Stephen","family":"Mahony","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mater Private Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8017-1904","authenticated-orcid":false,"given":"Roger J","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mater Private Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5224-6393","authenticated-orcid":false,"given":"Robert A","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mater Private Hospital, Dublin, Ireland"},{"name":"School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"2021031118311575800_ytab082-B1","first-page":"56","volume-title":"Clinical Aspect of Myocardial Injury: From Ischemia to Heart Failure","author":"Sato","year":"1990"},{"key":"2021031118311575800_ytab082-B2","doi-asserted-by":"crossref","first-page":"e013701","DOI":"10.1161\/JAHA.119.013701","article-title":"Short- and long-term prognosis of patients with takotsubo syndrome based on different triggers: importance of the physical 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