Beneficial effects of intravenous beta-blockers in Tako-Tsubo syndrome with dynamic left ventricular outflow tract obstruction and severe haemodynamic impairment

Abstract

Article history: Received 22 September 2014 Accepted 27 September 2014 Available online 5 October 2014 tion but with negative T waves in V1 to V5. There was no recent history of psychological stress. Physical examination revealed bibasilar crackles and a lowblood pressure (80/45mmHg). Shewas treatedwith heparin, aspirin, and ticagrelor for a suspected acute coronary syndrome ruled out by cardiac catheterizationwhich revealed a severeMRwith a typical apical ballooning of the left ventricle (Fig. 1). Treatment consisted of dobutamine (10 mcg/kg/min), non-invasive ventilation, intra-aortic balloon pump (IABP), diuretics. Upon admission in our ICU, patient