therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-81563033-8344РостГМУ10.21886/2712-8156-2021-2-3-94-105therapeutic-150Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCLINICAL CASESДинамическая обструкция выводного тракта левого желудочка как возможное осложнение кардиомиопатии такоцубоDynamic obstruction of the left ventricular outflow tract as a possible complication of takotsubo cardiomyopathyhttps://orcid.org/0000-0002-5588-0768ДонецЕ. К.DonetsE. K.

Екатерина Константиновна Донец, кардиолог отделения экстренной  кардиологии № 2

Краснодар

Ekaterina K. Donets, cardiologist of the Department of Emergency Cardiology № 2

Krasnodar

donecekaterina23@gmail.comhttps://orcid.org/0000-0002-5866-506XНамитоковА. М.NamitokovA. M.

Алим Муратович Намитоков, к.м.н., заведующий отделением экстренной кардиологии № 2

Краснодар

Alim M. Namitokov, PhD, Head of the Department of Emergency Cardiology № 2

Krasnodar

https://orcid.org/0000-0002-7538-0437КручиноваС. В.KruchinovaS. V.

София Владимировна Кручинова, кардиолог кардиологического отделения № 1

Краснодар

Sofia V. Kruchinova, cardiologist of the Department of Emergency Cardiology № 1

Krasnodar

https://orcid.org/0000-0001-8600-0199КосмачеваЕ. Д.KosmachevaH. D.

Елена Дмитриевна Космачева, д.м.н., проф., заместитель главного врача по медицинской части

Краснодар

Helen D. Kosmacheva, M.D, Deputy Chief Physician for Medical Care

Krasnodar

ГБУЗ «Научно-исследовательский институт — Краевая клиническая больница № 1 им. С.В. Очаповского»РоссияS.V. Ochapovsky Scientific institution — Regional Clinical Hospital №1Russian Federation2021290820212394105Copyright © Донец Е.К., Намитоков А.М., Кручинова С.В., Космачева Е.Д., 20212021Донец Е.К., Намитоков А.М., Кручинова С.В., Космачева Е.Д.Donets E.K., Namitokov A.M., Kruchinova S.V., Kosmacheva H.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/150

Кардиомиопатия такоцубо — относительно доброкачественное состояние, характеризующееся стресс-индуцированным гипо- и акинезом верхушечных сегментов миокарда на фоне сохранной функции базальных сегментов. При присоединении обструкции выводного тракта левого желудочка за счёт гиперкинеза базальных сегментов состояние и прогноз пациента существенно ухудшаются. Данное состояние по гемодинамическим параметрам сходно с обструкцией выводного тракта левого желудочка у пациентов с гипертрофической кардиомиопатией, однако за счёт быстрого развития способно приводить к формированию острой сердечной недостаточности на фоне синдрома малого выброса и острой митральной недостаточности. В данной статье представлен литературный обзор, содержащий информацию об эпидемиологии, патофизиологии и диагностике данного заболевания, а также клинический случай развития острой сердечной недостаточности с обструкцией выводного тракта левого желудочка у пациентки с синдромом такоцубо.

Takotsubo cardiomyopathy is a relatively benign condition characterized by stress-induced hypo- and akinesis of the apical segments of the myocardium against the background of intact function of the basal segments. With the addition of obstruction of the left ventricular outflow tract (LVOT) due to hyperkinesis of the basal segments, the patient’s condition and prognosis significantly worsens. In terms of hemodynamic parameters, this situation is similar to obstruction of LVOT in patients with hypertrophic cardiomyopathy, however, due to its rapid development, it can lead to the formation of acute heart failure against the background of low ejection syndrome and acute mitral insufficiency. This article presents a literature review, information on the epidemiology, pathophysiology and diagnosis of this disease, as well as a clinical case of the development of acute heart failure with obstruction of the left ventricular outflow tract and progression of takotsubo syndrome.

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The authors declare that there are no conflicts of interest present.