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During physical examination, the patient was hypotensive and there were signs of left-sided heart failure and a loud systolic murmur. Echocardiogram showed apical ballooning with dynamic left ventricular outflow tract obstruction, based on systolic anterior motion of the mitral valve with important mitral valve regurgitation. In the acute setting, the cardiogenic shock was treated cautiously with fluid resuscitation and intravenous metoprolol, resulting in direct stabilisation of her haemodynamic condition. As a codiagnosis, there was a significant stenosis of left anterior descending artery, which was treated successfully by percutaneous coronary intervention with drug eluting stents. During follow-up, left ventricular function normalised, and the left ventricular outflow tract obstruction, systolic anterior motion of mitral valve and related mitral regurgitation all resolved.<\/jats:p>","DOI":"10.1136\/bcr-2020-240010","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T12:46:34Z","timestamp":1616589994000},"page":"e240010","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Dynamic left ventricular outflow tract obstruction in Takotsubo cardiomyopathy resulting in cardiogenic shock"],"prefix":"10.1136","volume":"14","author":[{"given":"Paulina M","family":"Conradi","sequence":"first","affiliation":[{"name":"Cardiology, Amsterdam UMC, Amsterdam, Noord-Holland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon B","family":"van Loon","sequence":"additional","affiliation":[{"name":"Cardiology, Amsterdam UMC, Amsterdam, Noord-Holland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Louis","family":"Handoko","sequence":"additional","affiliation":[{"name":"Cardiology, Amsterdam UMC, Amsterdam, Noord-Holland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"2025082723022330000_14.3.e240010.1","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.120403"},{"key":"2025082723022330000_14.3.e240010.2","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.ijcard.2012.09.183","article-title":"History of takotsubo syndrome: is the syndrome really described as a disease entity first in 1990? some inaccuracies","volume":"166","author":"Y-Hassan","year":"2013","journal-title":"Int J Cardiol"},{"key":"2025082723022330000_14.3.e240010.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.05.002"},{"key":"2025082723022330000_14.3.e240010.4","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1093\/eurheartj\/ehy076","article-title":"International expert consensus document on takotsubo syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"2025082723022330000_14.3.e240010.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.027121"},{"key":"2025082723022330000_14.3.e240010.6","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-005-8555-8"},{"key":"2025082723022330000_14.3.e240010.7","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1093\/eurheartj\/ehy077","article-title":"International expert consensus document on takotsubo syndrome (Part II): diagnostic workup, outcome, and management","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"2025082723022330000_14.3.e240010.8","doi-asserted-by":"crossref","unstructured":"Chatterjee K , Hutchison SJ , Chou TM . 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