Asymmetric septal hypertrophy complicated by dynamic left ventricular obstruction after intra-aortic balloon counterpulsation placement in the setting of anterior myocardial infarction.

We report the case of a 74-year-old patient admitted for acute anterior myocardial infarction and treated by intravenous thrombolysis. Because of hemodynamic instability, an intra-aortic balloon pump (IABP) was inserted. However, the patient's systolic blood pressure deteriorated early after IABP placement. Echocardiography revealed a dynamic left ventricular outflow tract obstruction occurring only during assisted ventricular systoles. Interruption of counterpulsation allowed complete resolution of the dynamic obstruction and improvement of hemodynamic status.