Takotsubo-like Transient Biventricular Dysfunction with Pressure Gradients

Abstract
A 78-year-old woman was admitted to our hospital due to chest oppressive sensation. Admission electrocardiography revealed ST-segment elevation in I, II, III, aVF and V2-6 leads. Left ventriculography showed apical akinesis and basal hyperkinesis with a pressure gradient of 60 mmHg between the left ventricular apex and the base. Right ventriculography also showed similar abnormal wall motion with a pressure gradient of 28 mmHg. Follow-up cardiac catheterization after 16 days showed normal wall motion with no pressure gradients. However, dobutamine stress (10 μg/kg/min) caused a pressure gradient of 60 mmHg between the left ventricular apex and the aorta.