Reversal of cardiogenic shock and severe mitral regurgitation through verapamil in hypertensive hypertrophic cardiomyopathy

Acute cardiogenic shock immediately after successful intervention for failed thrombolysis

We report the case of a 60-year-old female with a history of hypertension who was admitted with an acute inferior myocardial infarction. She received rescue percutaneous transluminal coronary angioplasty/stenting of an occluded right coronary artery for failed thrombolysis with a good initial result. However, this was immediately complicated by cardiogenic shock characterized by left ventricular outflow tract (LVOT) gradient. She was treated with intravenous fluids and adrenaline. Predischarge echocardiography showed no LVOT gradient and features of left ventricular hypertrophy that mainly affected the septum.