Dobutamine-Precipitated Apical Ballooning with Left Ventricular Outflow Tract Obstruction

Takotsubo cardiomyopathy, or transient apical ballooning syndrome, is a recently recog-nized form of transient left ventricular dysfunction that is presumably caused by stress. Takotsubo cardiomyopathy can clinically resemble an acute coronary syndrome. Reported cases have been preceded by emotional stress or medical illness. Herein, we report a fatal case of takotsubo cardiomyopathy that followed a dobutamine stress test. We believe that the dobutamine infusion led to stress-induced cardiomyopathy with a dynamic left ventricular outflow tract obstruction. To our knowledge, there is only 1 other report of an association between dobutamine infusion and the development of takotsubo cardiomyop-athy. (Tex Heart Inst J 2008;35(1):73-5) akotsubo cardiomyopathy, also known as transient apical ballooning syn-drome, is a form of transient left ventricular (LV) dysfunction that is pre-sumed to be triggered by stress. Takotsubo cardiomyopathy can mimic an acute coronary syndrome. Reported cases have been preceded by emotional stress or medical illness. Herein, we report a case of takotsubo cardiomyopathy that appears to have been caused by a dobutamine stress test