article · JACC Case Reports
BACKGROUND: Takotsubo syndrome presents with a wide spectrum of clinical manifestations. CASE SUMMARY: A 46-year-old woman presented with chest pain mimicking acute coronary syndrome. Coronary angiography excluded obstructive coronary disease, and imaging findings confirmed Takotsubo syndrome complicated by complete atrioventricular block and left ventricular outflow tract obstruction with mitral regurgitation. The patient underwent permanent pacemaker implantation and was started on beta-blocker therapy with angiotensin-converting enzyme inhibitors. Subsequent clinical and echocardiographic recovery was observed. DISCUSSION: The coexistence of complete heart block and left ventricular outflow tract obstruction-related mitral regurgitation in Takotsubo syndrome is rare and poses significant therapeutic challenges. TAKE-HOME MESSAGES: This case highlights the complexity of management and provides insights into the underlying pathophysiological mechanisms of theses complications.
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DOI: 10.1016/j.jaccas.2026.108359
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